CC BY 4.0 · Pharmaceutical Fronts 2024; 06(01): e20-e28
DOI: 10.1055/s-0043-1777440
Review Article

Advances of Microneedle Patch in Diabetic Wound Healing

Yong-Nian Zeng#
1   Key Laboratory of Combinatorial Biosynthesis and Drug Discovery (Ministry of Education), School of Pharmaceutical Sciences, Wuhan University, Wuhan, People's Republic of China
,
Yin-Li Jin#
1   Key Laboratory of Combinatorial Biosynthesis and Drug Discovery (Ministry of Education), School of Pharmaceutical Sciences, Wuhan University, Wuhan, People's Republic of China
,
Wei Li
1   Key Laboratory of Combinatorial Biosynthesis and Drug Discovery (Ministry of Education), School of Pharmaceutical Sciences, Wuhan University, Wuhan, People's Republic of China
› Author Affiliations


Abstract

Wound healing is an intricate and orderly process of events that occur in response to external trauma, resulting in tissue repair and reconstruction. This process typically involves three phases, including inflammation, angiogenesis, and extracellular matrix remodeling, and any disruption to this process may delay the healing of the wound. Chronic wounds associated with diabetes, in particular, are notorious because they are difficult to handle in a timely and orderly manner. During the treatment of the disease, drugs usually accumulate in the stratum corneum due to the skin barrier, leading to a reduction of the drug's bioavailability. Encouragingly, among the treatment strategies, microneedles (MNs) represent a novel and painless drug delivery method that promotes wound healing in diabetic patients by enabling the drug to reach the dermal layer efficiently. In this review, recent advances of MNs in the treatment of diabetic wound healing are summarized by categorizing the designs and strategies. We finally provide an outlook on the prospects and challenges of MN-based therapies for diabetic wound healing in the future.

# These authors contributed equally.




Publication History

Received: 02 August 2023

Accepted: 12 November 2023

Article published online:
06 December 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Banday MZ, Sameer AS, Nissar S. Pathophysiology of diabetes: an overview. Avicenna J Med 2020; 10 (04) 174-188
  • 2 Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol 2018; 14 (02) 88-98
  • 3 Liu J, Qu M, Wang C. et al. A Dual-cross-linked hydrogel patch for promoting diabetic wound healing. Small 2022; 18 (17) e2106172
  • 4 Seo SG, Yeo JH, Kim JH, Kim JB, Cho TJ, Lee DY. Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects. Exp Mol Med 2013; 45 (11) e62
  • 5 Wachtel TJ, Silliman RA, Lamberton P. Prognostic factors in the diabetic hyperosmolar state. J Am Geriatr Soc 1987; 35 (08) 737-741
  • 6 Chang M, Nguyen TT. Strategy for treatment of infected diabetic foot ulcers. Acc Chem Res 2021; 54 (05) 1080-1093
  • 7 Li Y, Cornelis B, Dusa A. et al. Accurate label-free 3-part leukocyte recognition with single cell lens-free imaging flow cytometry. Comput Biol Med 2018; 96: 147-156
  • 8 Balasubramanian GV, Chockalingam N, Naemi R. The role of cutaneous microcirculatory responses in tissue injury, inflammation and repair at the foot in diabetes. Front Bioeng Biotechnol 2021; 9: 732753
  • 9 Sinwar PD. The diabetic foot management - recent advance. Int J Surg 2015; 15: 27-30
  • 10 Fonseca V. Clinical significance of targeting postprandial and fasting hyperglycemia in managing type 2 diabetes mellitus. Curr Med Res Opin 2003; 19 (07) 635-641
  • 11 Husain M, Agrawal YO. Antimicrobial remedies and emerging strategies for the treatment of diabetic foot ulcers. Curr Diabetes Rev 2023; 19 (05) e280222201513
  • 12 Ohl CA, Luther VP. Antimicrobial stewardship for inpatient facilities. J Hosp Med 2011; 6 (Suppl. 01) S4-S15
  • 13 Liang Y, Yang C, Lin Y. et al. Matrix metalloproteinase 9 induces keratinocyte apoptosis through FasL/Fas pathway in diabetic wound. Apoptosis 2019; 24 (7–8): 542-551
  • 14 Yang Z, Chen H, Yang P. et al. Nano-oxygenated hydrogels for locally and permeably hypoxia relieving to heal chronic wounds. Biomaterials 2022; 282: 121401
  • 15 Zeng X, Chen B, Wang L. et al. Chitosan@Puerarin hydrogel for accelerated wound healing in diabetic subjects by miR-29ab1 mediated inflammatory axis suppression. Bioact Mater 2022; 19: 653-665
  • 16 Yuan M, Liu K, Jiang T. et al. GelMA/PEGDA microneedles patch loaded with HUVECs-derived exosomes and Tazarotene promote diabetic wound healing. J Nanobiotechnology 2022; 20 (01) 147
  • 17 Zhang Y, An D, Pardo Y. et al. High-water-content and resilient PEG-containing hydrogels with low fibrotic response. Acta Biomater 2017; 53: 100-108
  • 18 Faraji Rad Z, Prewett PD, Davies GJ. An overview of microneedle applications, materials, and fabrication methods. Beilstein J Nanotechnol 2021; 12: 1034-1046
  • 19 Kim JS, Lee SK, Doh H, Kim MY, Kim DK. Real-time tracking of highly luminescent mesoporous silica particles modified with europium β-diketone chelates in living cells. Nanomaterials (Basel) 2021; 11 (02) 343
  • 20 Jamaledin R, Yiu CKY, Zare EN. et al. Advances in antimicrobial microneedle patches for combating infections. Adv Mater 2020; 32 (33) e2002129
  • 21 Ahmed Saeed Al-Japairai K, Mahmood S, Hamed Almurisi S. et al. Current trends in polymer microneedle for transdermal drug delivery. Int J Pharm 2020; 587: 119673
  • 22 Zhang QR, Yang X, Li Z. et al. Effects of reactive oxygen species-responsive antibacterial microneedles on the full-thickness skin defect wounds with bacterial colonization in diabetic mice [in Chinese]. Zhonghua Shao Shang Za Zhi 2021; 37 (11) 1024-1035
  • 23 Permana AD, Mir M, Utomo E, Donnelly RF. Bacterially sensitive nanoparticle-based dissolving microneedles of doxycycline for enhanced treatment of bacterial biofilm skin infection: a proof of concept study. Int J Pharm X 2020; 2: 100047
  • 24 Liu W, Zhai X, Zhao X. et al. Multifunctional double-layer and dual drug-loaded microneedle patch promotes diabetic wound healing. Adv Healthc Mater 2023; 12 (23) e2300297
  • 25 Ullah A, Jang M, Khan H. et al. Microneedle array with a pH-responsive polymer coating and its application in smart drug delivery for wound healing. Sens Actuators B Chem 2021; 345: 130441
  • 26 Xiong Y, Chen L, Liu P. et al. All-in-one: multifunctional hydrogel accelerates oxidative diabetic wound healing through timed-release of exosome and fibroblast growth factor. Small 2022; 18 (01) e2104229
  • 27 Hu X, Yang L, Sun Z. et al. Break-in period ≤24 hours as an option for urgent-start peritoneal dialysis in patients with diabetes. Front Endocrinol (Lausanne) 2022; 13: 936573
  • 28 Rensma SP, van Sloten TT, Ding J. et al. Type 2 diabetes, change in depressive symptoms over time, and cerebral small vessel disease: longitudinal data of the AGES-reykjavik study. Diabetes Care 2020; 43 (08) 1781-1787
  • 29 Ma W, Zhang X, Liu Y. et al. Polydopamine decorated microneedles with Fe-MSC-derived nanovesicles encapsulation for wound healing. Adv Sci (Weinh) 2022; 9 (13) e2103317
  • 30 Yamamoto M, Sato T, Beren J, Verthelyi D, Klinman DM. The acceleration of wound healing in primates by the local administration of immunostimulatory CpG oligonucleotides. Biomaterials 2011; 32 (18) 4238-4242
  • 31 Krismastuti FS, Cavallaro A, Prieto-Simon B, Voelcker NH. Toward multiplexing detection of wound healing biomarkers on porous silicon resonant microcavities. Adv Sci (Weinh) 2016; 3 (06) 1500383
  • 32 Lazzarini PA, Jarl G, Gooday C. et al. Effectiveness of offloading interventions to heal foot ulcers in persons with diabetes: a systematic review. Diabetes Metab Res Rev 2020; 36 (suppl 1, suppl 1): e3275
  • 33 Chen CY, Yin H, Chen X. et al. Ångstrom-scale silver particle-embedded carbomer gel promotes wound healing by inhibiting bacterial colonization and inflammation. Sci Adv 2020; 6 (43) eaba0942
  • 34 Tran PL, Patel S, Hamood AN. et al. A novel organo-selenium bandage that inhibits biofilm development in a wound by gram-positive and gram-negative wound pathogens. Antibiotics (Basel) 2014; 3 (03) 435-449
  • 35 Chen S, Wang H, Su Y. et al. Mesenchymal stem cell-laden, personalized 3D scaffolds with controlled structure and fiber alignment promote diabetic wound healing. Acta Biomater 2020; 108: 153-167
  • 36 Gao S, Zhang W, Zhai X. et al. An antibacterial and proangiogenic double-layer drug-loaded microneedle patch for accelerating diabetic wound healing. Biomater Sci 2023; 11 (02) 533-541
  • 37 Yin M, Wu J, Deng M. et al. Multifunctional magnesium organic framework-based microneedle patch for accelerating diabetic wound healing. ACS Nano 2021; 15 (11) 17842-17853
  • 38 Ning T, Yang F, Chen D. et al. Synergistically detachable microneedle dressing for programmed treatment of chronic wounds. Adv Healthc Mater 2022; 11 (11) e2102180
  • 39 Guan G, Zhang Q, Jiang Z. et al. Multifunctional silk fibroin methacryloyl microneedle for diabetic wound healing. Small 2022; 18 (51) e2203064
  • 40 Su Y, Andrabi SM, Shahriar SMS, Wong SL, Wang G, Xie J. Triggered release of antimicrobial peptide from microneedle patches for treatment of wound biofilms. J Control Release 2023; 356: 131-141
  • 41 Lei X, Li M, Wang C. et al. Degradable microneedle patches loaded with antibacterial gelatin nanoparticles to treat staphylococcal infection-induced chronic wounds. Int J Biol Macromol 2022; 217: 55-65
  • 42 Chi J, Sun L, Cai L. et al. Chinese herb microneedle patch for wound healing. Bioact Mater 2021; 6 (10) 3507-3514
  • 43 Zeng Z, Jiang G, Sun Y. et al. Rational design of flexible microneedles coupled with CaO2@PDA-loaded nanofiber films for skin wound healing on diabetic rats. Biomater Sci 2022; 10 (18) 5326-5339
  • 44 Zhang J, Liu H, Yu Q. et al. Hair derived microneedle patches for both diabetic foot ulcer prevention and healing. ACS Biomater Sci Eng 2023; 9 (01) 363-374
  • 45 Lou BS, Hsieh JH, Chen CM. et al. Helium/argon-generated cold atmospheric plasma facilitates cutaneous wound healing. Front Bioeng Biotechnol 2020; 8: 683
  • 46 Yang J, Chu Z, Jiang Y. et al. Multifunctional hyaluronic acid microneedle patch embedded by cerium/zinc-based composites for accelerating diabetes wound healing. Adv Healthc Mater 2023; 12 (24) e2300725
  • 47 Wang G, Chen JJ, Deng WY, Ren K, Yin SH, Yu XH. CTRP12 ameliorates atherosclerosis by promoting cholesterol efflux and inhibiting inflammatory response via the miR-155-5p/LXRα pathway. Cell Death Dis 2021; 12 (03) 254
  • 48 Gan JJ, Zhang XX, Ma WJ. et al. Antibacterial, adhesive, and MSC exosomes encapsulated microneedles with spatio-temporal variation functions for diabetic wound healing. Nano Today 2022; 47: 101630
  • 49 Long LY, Liu W, Li L. et al. Dissolving microneedle-encapsulated drug-loaded nanoparticles and recombinant humanized collagen type III for the treatment of chronic wound via anti-inflammation and enhanced cell proliferation and angiogenesis. Nanoscale 2022; 14 (04) 1285-1295
  • 50 Liu J, Chen Z, Wang J. et al. Encapsulation of curcumin nanoparticles with MMP9-responsive and thermos-sensitive hydrogel improves diabetic wound healing. ACS Appl Mater Interfaces 2018; 10 (19) 16315-16326
  • 51 Zhao E, Xiao T, Tan Y. et al. Separable microneedles with photosynthesis-driven oxygen manufactory for diabetic wound healing. ACS Appl Mater Interfaces 2023; 15 (06) 7725-7734
  • 52 Hu F, Gao Q, Liu J. et al. Smart microneedle patches for wound healing and management. J Mater Chem B Mater Biol Med 2023; 11 (13) 2830-2851
  • 53 Kang JI, Park KM, Park KD. Oxygen-generating alginate hydrogels as a bioactive acellular matrix for facilitating wound healing. J Ind Eng Chem 2019; 69: 397-404
  • 54 Schreml S, Szeimies RM, Prantl L, Karrer S, Landthaler M, Babilas P. Oxygen in acute and chronic wound healing. Br J Dermatol 2010; 163 (02) 257-268
  • 55 Zhang X, Chen G, Liu Y, Sun L, Sun L, Zhao Y. Black phosphorus-loaded separable microneedles as responsive oxygen delivery carriers for wound healing. ACS Nano 2020; 14 (05) 5901-5908
  • 56 Kim HS, Sun X, Lee JH, Kim HW, Fu X, Leong KW. Advanced drug delivery systems and artificial skin grafts for skin wound healing. Adv Drug Deliv Rev 2019; 146: 209-239
  • 57 Xu Y, Wu XY, Zhang XX. et al. Living microneedle patch with adipose-derived stem cells embedding for diabetic ulcer healing. Adv Funct Mater 2023; 33 (01) 2209986
  • 58 Chi J, Zhang X, Chen C, Shao C, Zhao Y, Wang Y. Antibacterial and angiogenic chitosan microneedle array patch for promoting wound healing. Bioact Mater 2020; 5 (02) 253-259
  • 59 Wu X, Huang D, Xu Y, Chen G, Zhao Y. Microfluidic templated stem cell spheroid microneedles for diabetic wound treatment. Adv Mater 2023; 35 (28) e2301064
  • 60 Bernardini D, Nasulewic A, Mazur A, Maier JA. Magnesium and microvascular endothelial cells: a role in inflammation and angiogenesis. Front Biosci 2005; 10: 1177-1182
  • 61 Shen X, Zhang Y, Ma P. et al. Fabrication of magnesium/zinc-metal organic framework on titanium implants to inhibit bacterial infection and promote bone regeneration. Biomaterials 2019; 212: 1-16
  • 62 Martins-Mendes D, Monteiro-Soares M, Boyko EJ. et al. The independent contribution of diabetic foot ulcer on lower extremity amputation and mortality risk. J Diabetes Complications 2014; 28 (05) 632-638
  • 63 Zhao Y, Luo L, Huang L. et al. In situ hydrogel capturing nitric oxide microbubbles accelerates the healing of diabetic foot. J Control Release 2022; 350: 93-106
  • 64 Yao S, Wang Y, Chi J. et al. Porous MOF microneedle array patch with photothermal responsive nitric oxide delivery for wound healing. Adv Sci (Weinh) 2022; 9 (03) e2103449
  • 65 Wang P, Wu J, Yang H. et al. Intelligent microneedle patch with prolonged local release of hydrogen and magnesium ions for diabetic wound healing. Bioact Mater 2023; 24: 463-476
  • 66 Guo Z, Liu H, Shi Z. et al. Responsive hydrogel-based microneedle dressing for diabetic wound healing. J Mater Chem B Mater Biol Med 2022; 10 (18) 3501-3511
  • 67 Liu T, Sun Y, Jiang G. et al. Porcupine-inspired microneedles coupled with an adhesive back patching as dressing for accelerating diabetic wound healing. Acta Biomater 2023; 160: 32-44
  • 68 Guo M, Wang Y, Gao B, He B. Shark tooth-inspired microneedle dressing for intelligent wound management. ACS Nano 2021; 15 (09) 15316-15327
  • 69 Zhang XX, Chen GP, Sun LY. et al. Claw-inspired microneedle patches with liquid metal encapsulation for accelerating incisional wound healing. Chem Eng J 2021; 406: 126741
  • 70 Monavarian M, Kader S, Moeinzadeh S, Jabbari E. Regenerative scar-free skin wound healing. Tissue Eng Part B Rev 2019; 25 (04) 294-311
  • 71 Zhang X, Wang Z, Jiang H. et al. Self-powered enzyme-linked microneedle patch for scar-prevention healing of diabetic wounds. Sci Adv 2023; 9 (28) eadh1415
  • 72 Li W, Li S, Fan X, Prausnitz MR. Microneedle patch designs to increase dose administered to human subjects. J Control Release 2021; 339 (339) 350-360
  • 73 Zhang S, Wang L, Xu T, Zhang X. Luminescent MOF-based nanofibers with visual monitoring and antibacterial properties for diabetic wound healing. ACS Appl Mater Interfaces 2023; 15 (07) 9110-9119
  • 74 Guo HS, Bai M, Zhu YN. et al. Pro-healing zwitterionic skin sensor enables multi-indicator distinction and continuous real-time monitoring. Adv Funct Mater 2021; 31: 21064