In this mini-review, we highlight the potential of the biopolymer bacterial cellulose to treat
damaged epithelial tissues. Epithelial tissues are cell sheets that delimitate both the external body surfaces
and the internal cavities and organs. Epithelia serve as physical protection to underlying organs,
regulate the diffusion of molecules and ions, secrete substances and filtrate body fluids, among other
vital functions. Because of their continuous exposure to environmental stressors, damage to epithelial
tissues is highly prevalent. Here, we first compare the properties of bacterial cellulose to the current
gold standard, collagen, and then we examine the use of bacterial cellulose patches to heal specific epithelial
tissues; the outer skin, the ocular surface, the oral mucosa and other epithelial surfaces. Special
emphasis is made on the dermis since, to date, this is the most widespread medical use of bacterial cellulose.
It is important to note that some epithelial tissues represent only the outermost layer of more
complex structures such as the skin or the cornea. In these situations, depending on the penetration of
the lesion, bacterial cellulose might also be involved in the regeneration of, for instance, inner connective
tissue.
Natural products suited for prophylaxis and therapy of inflammatory diseases have gained increasing importance. These compounds could be beneficially integrated into bacterial cellulose (BC), which is a natural hydropolymer applicable as a wound dressing and drug delivery system alike. This study presents experimental outcomes for a natural anti-inflammatory product concept of boswellic acids from frankincense formulated in BC. Using esterification respectively (resp.) oxidation and subsequent coupling with phenylalanine and tryptophan, post-modification of BC was tested to facilitate lipophilic active pharmaceutical ingredient (API) incorporation. Diclofenac sodium and indomethacin were used as anti-inflammatory model drugs before the findings were transferred to boswellic acids. By acetylation of BC fibers, the loading efficiency for the more lipophilic API indomethacin and the release was increased by up to 65.6% and 25%, respectively, while no significant differences in loading could be found for the API diclofenac sodium. Post-modifications could be made while preserving biocompatibility, essential wound dressing properties and anti-inflammatory efficacy. Eventually, in vitro wound closure experiments and evaluations of the effect of secondary dressings completed the study.
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