International Journal of Nanomedicine (Jun 2024)
Dual Drug-Loaded Coaxial Nanofiber Dressings for the Treatment of Diabetic Foot Ulcer
Abstract
Dunia A Alzahrani,1 Khulud A Alsulami,1 Fatemah M Alsulaihem,1 Abrar A Bakr,1 Rayan Y Booq,2 Ahmed J Alfahad,3 Alhassan H Aodah,1 Samar A Alsudir,4 Amany A Fathaddin,5,6 Essam J Alyamani,2 Aliyah A Almomen,7 Essam A Tawfik1 1Advanced Diagnostics and Therapeutics Technologies Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia; 2Wellness and Preventative Medicine Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia; 3Waste Management and Recycling Technologies Institute, Sustainability and Environment Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia; 4Bioengineering Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia; 5Department of Pathology, College of Medicine, King Saud University, Riyadh, 12372, Saudi Arabia; 6King Saud University Medical City, Riyadh, 12372, Saudi Arabia; 7Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi ArabiaCorrespondence: Essam A Tawfik, Email [email protected]: Diabetes mellitus is frequently associated with foot ulcers, which pose significant health risks and complications. Impaired wound healing in diabetic patients is attributed to multiple factors, including hyperglycemia, neuropathy, chronic inflammation, oxidative damage, and decreased vascularization.Rationale: To address these challenges, this project aims to develop bioactive, fast-dissolving nanofiber dressings composed of polyvinylpyrrolidone loaded with a combination of an antibiotic (moxifloxacin or fusidic acid) and anti-inflammatory drug (pirfenidone) using electrospinning technique to prevent the bacterial growth, reduce inflammation, and expedite wound healing in diabetic wounds.Results: The fabricated drug-loaded fibers exhibited diameters of 443 ± 67 nm for moxifloxacin/pirfenidone nanofibers and 488 ± 92 nm for fusidic acid/pirfenidone nanofibers. The encapsulation efficiency, drug loading and drug release studies for the moxifloxacin/pirfenidone nanofibers were found to be 70 ± 3% and 20 ± 1 μg/mg, respectively, for moxifloxacin, and 96 ± 6% and 28 ± 2 μg/mg, respectively, for pirfenidone, with a complete release of both drugs within 24 hours, whereas the fusidic acid/pirfenidone nanofibers were found to be 95 ± 6% and 28 ± 2 μg/mg, respectively, for fusidic acid and 102 ± 5% and 30 ± 2 μg/mg, respectively, for pirfenidone, with a release rate of 66% for fusidic acid and 80%, for pirfenidone after 24 hours. The efficacy of the prepared nanofiber formulations in accelerating wound healing was evaluated using an induced diabetic rat model. All tested formulations showed an earlier complete closure of the wound compared to the controls, which was also supported by the histopathological assessment. Notably, the combination of fusidic acid and pirfenidone nanofibers demonstrated wound healing acceleration on day 8, earlier than all tested groups.Conclusion: These findings highlight the potential of the drug-loaded nanofibrous system as a promising medicated wound dressing for diabetic foot applications.Keywords: diabetes mellitus, diabetic foot ulcers, nanofibers, electrospinning, drug delivery, wound healing, moxifloxacin, fusidic acid, pirfenidone