In April 2017, 252 articles about chitosan and chitosan derivatives were published. The International Journal of Biological Macromolecules published the highest number of chitosan-related articles (23), followed by Colloids and Surfaces B: Biointerfaces (7) and Carbohydrate Polymers (6). Researchers from China (48 articles) are as usually on the top of the list of leading countries in chitosan research. Germany can also be found among the top 10, with 5 publications in April 2017.

Table: Countries with the highst number of articels about chitosan and chitosan derivatives in April 2017. Quelle: gopubmed

Chitosan is an extensively studied biomaterial for application in skin wound healing as film or hydrogel. Reasons therefore are the ability of water absorption by chitosan hydrogels, to provide a moist wound healing environment but also prevent the accumulation of liquids. Skin wound healing requires cell proliferation and tissue formation, with angiogenesis and granulation, as well as tissue remodeling. Fibroblasts differentiate to myofibroblasts, excrete important growth factors and synthesize necessary matrix proteins and fibers.

Peptide-modified Chitosan Hydrogel accelerates skin wound healing by promoting fibroblast proliferation, migration and secretion

Chen X., Zhang M., Chen S. et al., Cell Transplantation, April 2017. [Epub ahead of print] doi: 10.3727/096368917X695687

In the first article, the effects of peptide SIKVAV (Ser-Ile-Lys-Val-Ala-Val)-modified chitosan (85% deacetylation degree, molecular weight 100,000) hydrogels in skin wound healing were investigated. The SIKVAV is a laminin alpha1-derived peptide and previous studies showed beneficial effects on fibroblast proliferation and migration, similar to laminin itself.
The researchers examined the capability of the peptide SIKVAV to promote fibroblast proliferation and migration, as well as secretion of growth factors.

Results

In vitro: Primary fibroblast incubated with different concentrations of peptide SIKVAV for 1, 2 or 3 days.

• Increased proliferation for concentrations > 100 µg/ml after 2/3 days
• Induced migration in a concentration dependent manner
• Increased growth factor (EGF, bFGF, TGF-β1, VEGF) secretion for 400 µg/ml

In addition, the SIKVAV-modified chitosan hydrogels were tested for the treatment of skin wound in mice. Skin wounds were created and mice were divided into four groups:

• Negative control group: without any treatment
• Positive control groups: peptide SIKVAV solution injections or a wound dressing containing chitosan
• Experimental group: peptide-modified chitosan hydrogel

In vivo: Results for application of peptide-modified chitosan hydrogels compared to negative and positive controls:

• improved re-epithelialization and enhanced collagen fiber presence at the wound site, verified by hematoxylin-eosin-staining
• stronger induction of angiogenesis at skin wound, verified by immunohistochemistry

Conclusion: The study showed the positive effect of peptide SIKVAV-modified chitosan hydrogel for skin wound healing. The modified hydrogels improved re-epithelialization, collagen fiber deposition and angiogenesis at the skin wound in a synergistic manner. Their application for wound treatment is promising.

Source: https://www.ncbi.nlm.nih.gov/pubmed/28447570

Following article by researchers from Philadelphia, which applied and investigated chitosan-based dressings in practice, is also very interesting.

The use of a chitosan dressing with silver in the management of paediatric burn wounds: a pilot study

Journal of wound care. Massand S., Cheema R., Brown S. et al., Journal of wound care, 26(sup4):S26-S30. April 2017. doi: 10.12968/jowc.2017.26.Sup4.S26.

In this pilot study, chitosan-based dressings with silver for burn wound treatment in paediatric clinic were investigated. Overall, 10 children with partial-thickness burns (12) were treated with silver containing chitosan dressings. Before application, wound dressings were moistened and controlled for possible shrinking. Wound healing of patients was monitored during follow-up visits. Average burn size was 3.6% of total body surface area of the child. The dressing was removed when wound had healed.

Results:

• No shrinkage through moisture
• Dressing stayed intact when removed
• No wound infections during the study

Conclusion: In comparison to commonly used hydrofibre dressings in clinical practice, chitosan-based dressings showed no shrinkage or degradation. Therefore, they are optimal for moist wound management and a promising alternative for traditional burn dressings.

Source: https://www.ncbi.nlm.nih.gov/pubmed/28379104

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