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Enhancement of wound healing by single-wall/multi-wall carbon nanotubes complexed with chitosan

Authors Kittana N, Assali M, Abu-Rass H, Lutz S, Hindawi R, Ghannam L, Zakarneh M, Mousa A

Received 9 August 2018

Accepted for publication 3 October 2018

Published 8 November 2018 Volume 2018:13 Pages 7195—7206

DOI https://doi.org/10.2147/IJN.S183342

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Farooq Shiekh

Peer reviewer comments 2

Editor who approved publication: Dr Thomas J Webster


Naim Kittana,1 Mohyeddin Assali,2 Hanood Abu-Rass,1 Susanne Lutz,3,4 Rama Hindawi,2 Lina Ghannam,2 Marah Zakarneh,2 Ahmad Mousa1

1Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine; 2Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine; 3Institute of Pharmacology and Toxicology, University Medical Center, Göttingen, Germany; 4German Center for Cardiovascular Research e.V., Partner Site, Göttingen, Germany

Background: Impaired wound healing is commonly associated with many health problems, including diabetes, bedsores and extensive burns. In such cases, healing often takes a long time, which subjects patients to various complications. This study aims to investigate whether single-wall or multi-wall carbon nanotubes complexed with chitosan hydrogel can improve wound healing.
Materials and methods: Initially, the effects of the complexes on the viability and functionality of fibroblasts were investigated in engineered connective tissues. Then, their activity on wound healing was investigated in a mouse model with induced full-thickness wounds, in which the wounds were treated daily with these complexes. Finally, the effect of the complexes on collagen deposition by fibroblasts was investigated in vitro.
Results: The engineered connective tissue studies showed that fibroblasts were viable in the presence of the complexes and were still able to effectively organize and contract the extracellular matrix. In vivo data showed that both types of complexes improved the re-epithelialization of the healing wounds; however, they also increased the percentage of wounds with higher fibrosis. In particular, the chitosan-multi-wall carbon nanotube complex significantly enhanced the extensiveness of this fibrosis, which is in line with in vitro data showing a concentration-dependent enhancement of collage deposition by these complexes. These observations were associated with an increase in inflammatory signs in the wound bed.
Conclusion: Single-wall and multi-wall carbon nanotubes complexed with chitosan improved the re-epithelialization of wounds, but an increase in fibrosis was detected.

Keywords: carbon nanotubes, chitosan, wound healing, re-epithelialization, fibrosis, inflammation

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