Leading OpinionMicrobial cellulose—the natural power to heal wounds☆
Introduction
Recent advances in the field of biomaterials and their medical applications indicate the significance and potential of various microbial polysaccharides in the development of novel classes of medical materials. Several of the microbially-derived polysaccharides possessing novel and interesting physical and biological properties already have been applied in biotechnology products or are presently being widely investigated (i.e. hyaluronic acid, dextran, alginate, scleroglucan). Among them, microbial cellulose (MC), a polymer synthesized in abundance by Acetobacter xylinum, belongs to the most promising class of biopolymers, despite the fact that its potential of becoming a high-value product of biotechnology has not yet been fully estimated or discovered [1]. The unique physical and mechanical properties of MC as well as its purity and uniformity determine applications that range from high-quality audio membranes [2] and electronic paper [3] to fuel cells [4] and medical materials [5], [6], [7]. This last, emerging area seems to be particularly important since many efforts have been devoted in recent years to explore new skin substitutes and modern wound dressing materials using tissue engineering approaches. Various polymeric materials recently have been investigated for wound dressing application yielding many successful outcomes, but the search for an ideal skin-graft substitute with properties and functionality similar to human skin is still continuing. We believe that MC, while chemically the same as plant cellulose, displays novel physical properties determined by the particular genetics of the organism. In such a case, MC has a distinctive nanofibrillar structure that may become a perfect matrix as an optimal wound healing environment.
Section snippets
Biosynthesis, structure and properties of MC
A. xylinum is a simple Gram-negative bacterium which has an ability to synthesize a large quantity of high-quality cellulose organized as twisting ribbons of microfibrillar bundles [8]. During the process of actual biosynthesis, various carbon compounds of the nutrition medium are utilized by the bacteria, then polymerized into single, linear β-1,4-glucan chains and finally secreted outside the cells through a linear row of pores located on their outer membrane. The subsequent assembly of the β
Brief overview of the commercialization potential of MC for wound care products
The first efforts to commercialize MC on a large scale were initiated by Johnson & Johnson in the early 1980s. This company pioneered in exploratory investigations on the medical application of MC in the treatment of different types of wounds [12], [13]. However, no data of any clinical trials involving the use of MC as a wound dressing has ever been published, according to our knowledge. The Johnson & Johnson Company did not launch any commercial product out of their inventions, most probably
MC as a wound healing system
Healing of skin wounds is a complex process which requires the involvement of many different tissues, cell types and matrix components [24], [25]. There are three major directions in which wound-healing research is aimed presently [25]: (a) improvement of wound healing by elements which may potentially accelerate healing and reduce scarring, (b) development of novel skin substitutes as equivalents of autograft skin, and (c) identification of signals that trigger the process of healing by
Clinical performance of MC wound dressing
There have been several publications and reports on the successful use of MC as a medical product. In 1990, Fontana et al. [5] first reported the application of cellulose pellicles of varying thickness, produced by Acetobacter, as temporary skin substitutes. The product, called Biofill®, has been used for several skin injury treatments such as basal cell carcinoma/skin graft, severe body burns, facial peeling, sutures, dermabrasions, skin lesions, chronic ulcers, and both donor and receptor
Perspectives
Down through the centuries, humans have used one form of cellulose or another in medical applications and wound care products. Now, through the serendipity of better understanding a novel form of cellulose assembled by bacteria, scientists are positioned to make good use of the unique properties of such materials. Knowing what we presently understand about the biosynthetic process, it is possible to envision genetic modification of cellulose producing microbe strains to customize particular
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Editor's Note: Leading Opinions: This paper is one of a newly instituted series of scientific articles that provide evidence-based scientific opinions on topical and important issues in biomaterials science. They have some features of an invited editorial but are based on scientific facts, and some features of a review paper, without attempting to be comprehensive. These papers have been commissioned by the Editor-in-Chief and reviewed for factual, scientific content by referees.