The benefits of using antimicrobial peptides in wound care have been studied for many years, but unfortunately, since the peptide degrades rapidly after contact with body fluids, it cannot be used practically because it simply breaks down before it has a positive effect. However, researchers at Chalmers University of Technology in Sweden have developed a new material, a hydrogel, that can suspend and protect peptides, which means they will not break down so easily. This innovative new technology will enable peptides to be used in dressings for the first time as wound care. Due to the unique properties of peptides, this technology can even be used to treat wounds with antibiotic-resistant bacteria. Martin Andersson, who led the research to develop this technology, introduced the benefits of this innovative product to Health Europa Quarterly (HEQ).

The biggest challenge in managing and treating wounds is infection. If the wound is infected, it can greatly hinder the healing process, and sometimes you may get such a serious infection, which can even be fatal. Another challenge is chronic wounds. These wounds will never heal, sometimes grow, cause prolonged discomfort to the patient, and often require surgical intervention. Chronic wounds are particularly difficult to treat patients with other diseases (such as diabetes), which can affect their ability to heal. In addition, if patients receive certain medications that limit their immune system, their wounds will become more difficult to treat. Taken together, chronic wounds and the risk of infection are the biggest challenges we face in wound care.

Hydrogel focuses on eradicating bacteria from wounds and surrounding skin. It is very effective because it has a fast, almost immediate killing effect. This is the so-called contact sterilization device, so bacteria will be killed as soon as they come into contact with the device. It is also attached to the surface, so when you remove the wound patch, you also remove the bacteria. One of the main benefits here is that it is very selective for bacteria, but at the same time, it has a wide range of efficiencies against different types of bacteria (including Gram-negative, Gram-positive or resistant strains). It is also proven to have very low toxicity, so it does not cause irritation or pain when applied to the skin. Low toxicity is very beneficial when healing wounds, because if the treatment has any toxicity, it will affect the tissue forming cells and hinder the healing process. In addition, because it is a hydrogel that contains a lot of water, it creates a moist environment for the wound, which is very suitable for promoting healing.

This is a faster process. As a device, it does not leach any material into the wound, ensuring that it maintains a local effect and does not need to be absorbed by the body in any way. And because it does not depend on release, you do not need to establish a certain dose or a certain concentration, which is a common thing with many other devices that release substances, in which you must reach a specific therapeutic dose before the product will work effectively.

As far as the function of the material is concerned, we are actually trying to imitate a part of our own innate immune system. The ultimate goal of peptides is what has been known for decades. Thousands of peptides have been identified and they exist in all living things. This is our natural way of trying to kill bacteria to prevent infection. Our immune system, if it is healthy and strong, will prevent us from being infected, but when it is weakened or hindered in any way, we will begin to encounter these problems as wounds heal. When you look at the mechanism of the use of these antimicrobial peptides, you will find that this is a very local effect. When you are invaded, immune cells will be activated, and they will begin to produce large amounts of these peptides at the site of infection. If you can get these peptides in relatively high concentrations, they can kill bacteria and prevent infections.

However, the problem lies in clinical translation of these peptides, because first of all, they are very unstable, very sensitive, and will be degraded by enzymes present in our blood. Systemic treatment with peptides is very difficult, because once it enters our body, they will degrade within a few seconds and become unusable. If you want to apply peptides directly to the wound topically, they will only be active for a few minutes or so, because they will degrade very quickly. This is our innovation. We have been able to create a material that retains these killing effects, but at the same time increases the stability of the peptides, allowing them to work for days instead of minutes. That's when we started to see the possibility of use in a clinical setting, because you can use these materials for many days before you need to replace them, at which time they will resolve the infection and promote healing.

Of course, there are some traditional methods to minimize infection, such as regular hand washing and disinfection to maintain a good level of hygiene, which is a common practice. However, this is a complicated topic. When talking with clinicians in Sweden, I found that although the operating room has become cleaner, the infection rate remains consistent, and in some cases even rises. Now, as the threat of drug-resistant strains increases, this makes it more difficult, because in some procedures, about 20% of patients may be infected, and if they are infected with drug-resistant strains, we lack treatment for them . It is important to find a way to reduce the infection rate. I think this can be done most effectively through prevention, and we should develop methods to prevent infection before it occurs. This is where the device is most effective. By using it in the early stage, before the bacteria grow and cause infection, before we get the proper biofilm and there is a problem to eradicate it, our device will be infected or even formed.

Two years ago, a start-up company started using this research. The company has patents on materials and material manufacturing methods. Now they are focusing on commercializing these materials into products. They mainly focus on wound care products such as wound dressings, and cooperate with companies to research veterinary medicines and traditional medicines. They are making progress along the regulatory path. Through the new MDR we now have in Europe, as well as veterinary work, the successful establishment of a product requires a lot of clinical testing, clinical trials and cooperation. Once approved by the regulatory authorities and organized for distribution, we hope it will become a symbol of wound care, change the way we treat wounds and prevent unnecessary infections.

Martin Andersson Professor of Chemistry and Chemical Engineering Chalmers University of Technology martin.andersson@chalmers.se www.chalmers.se/en/

This article is from Health Europa Issue 18. Click here to get a free subscription now.

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