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Review
. 2022 Sep 8;10(9):2226.
doi: 10.3390/biomedicines10092226.

The Discovery and Development of Natural-Based Biomaterials with Demonstrated Wound Healing Properties: A Reliable Approach in Clinical Trials

Nur Izzah Md Fadilah  1 , Manira Maarof  1 , Antonella Motta  2 , Yasuhiko Tabata  3 , Mh Busra Fauzi  1
Affiliations
Review

The Discovery and Development of Natural-Based Biomaterials with Demonstrated Wound Healing Properties: A Reliable Approach in Clinical Trials

Nur Izzah Md Fadilah et al. Biomedicines. .

Abstract

Current research across the globe still focuses strongly on naturally derived biomaterials in various fields, particularly wound care. There is a need for more effective therapies that will address the physiological deficiencies underlying chronic wound treatment. The use of moist bioactive scaffolds has significantly increased healing rates compared to local and traditional treatments. However, failure to heal or prolonging the wound healing process results in increased financial and social stress imposed on health institutions, caregivers, patients, and their families. The urgent need to identify practical, safe, and cost-effective wound healing scaffolding from natural-based biomaterials that can be introduced into clinical practice is unequivocal. Naturally derived products have long been used in wound healing; however, clinical trial evaluations of these therapies are still in their infancy. Additionally, further well-designed clinical trials are necessary to confirm the efficacy and safety of natural-based biomaterials in treating wounds. Thus, the focus of this review is to describe the current insight, the latest discoveries in selected natural-based wound healing implant products, the possible action mechanisms, and an approach to clinical studies. We explore several tested products undergoing clinical trials as a novel approach to counteract the debilitating effects of impaired wound healing.

Keywords: biomaterial; clinical trial; dressings; natural products; tissue-engineered skin; wound healing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Four different phases of wound healing that are involved different cellular events and mechanisms, as well as the type and purpose of wound care used at different time points after injury. Created with BioRender.com (accessed on 26 July 2022).
Figure 2
Figure 2
Chemokines in early and late phases of wound healing. (a) Early wound healing, including clot formation, inflammation, and proliferation. (1) Clot formation occurs to prevent the loss of blood, and (2) platelets are activated and release (3) α-granules, which in turn release (4) CXCL4 as an early inhibitor of angiogenesis. Once the clot has fully formed, other chemokines such as CXCL8, CXCL1, and CXCL2 are released by α-granules to recruit inflammatory cells, including (5) neutrophils and (6) macrophages. Neutrophils are increased early in the healing process, then macrophages soon take over as the primary inflammatory cell. Neutrophils and macrophages release (7) chemokines such as CCL2, CCL3, and CCL5 into the wound to promote the recruitment of more inflammatory cells that release pro-angiogenic growth factors, which in turn (8) increase neovessel formation in the wound. (b) Late wound healing is the remodeling stage. In this stage, the wound is fully healed and (1) a scar has formed. Type III collagen converts to (2) type I collagen to promote scar formation and create a more stable wound seal. During the remodeling process (3), angiostatic chemokines (CXCL10, CXCL11) promote the (4) regression of neovessels, as there is no longer a requirement for enhanced blood flow or the recruitment of immunological cells to the site. The symbol ↓ indicates decrease; ↑ indicates increase. The figure has been reprinted (adapted) with permission from Ref. [60] under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (accessed on 26 June 2022)).
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