A catechol-modified quaternized chitosan/PEG hydrogel for diabetic wound healing: synergistic effects of TGF-β3 delivery, angiogenesis, and antibacterial activity

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Diabetic foot ulcers (DFUs) represent a challenging chronic wound model, often plagued by biofilm formation that sustains inflammation and impedes healing. Transforming growth factor-beta 3 (TGF-β3) is a promising cytokine for tissue regeneration, yet its delivery within the hostile, infected wound milieu remains problematic. This study addresses the intertwined challenges of microbial resistance and healing impairment by developing a multifunctional injectable hydrogel that couples inherent antibacterial activity with sustained TGF-β3 release. Methods A catechol-modified quaternized chitosan (QCS-Catechol) was synthesized and crosslinked with benzaldehyde-terminated 4-arm polyethylene glycol (4-arm PEG-CHO) to form the BP-QS/TGF-β3 hydrogel. Its physicochemical properties, injectability, adhesion, and mechanical strength were characterized. Antibacterial efficacy was evaluated against Staphylococcus aureus and Escherichia coli . The biocompatibility and therapeutic potential of the BP-QS/TGF-β3 hydrogel were evaluated through in vitro assays (CCK-8, apoptosis, hemolysis) and in a streptozotocin-induced diabetic mouse model, respectively, against controls including PBS, BP-QS (blank hydrogel), and free TGF-β3 solution. Wound closure kinetics, histology (H&E, Masson's trichrome), and immunohistochemistry (CD31, Ki-67) were analyzed. Results The BP-QS/TGF-β3 hydrogel d

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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