3.4.1. Studying migration.
Cells migration is decomposed into steps (polarization, actin polymerization, assembly, and disassembly of focal adhesions) leading to spatial cell asymmetry and cell body translocation [
19]. Environmental chemical and physical properties are leading to a variety of signals, triggering signalization cascade, and ultimately impacting migratory behavior: single or collective, amoeboid, or mesenchymal, focal adhesion independent or dependent, directionally persistent, or not. In contrast with single cell migration, during collective migration, cells will be influenced both by cell-cell junction (described as implicated in mechanosensing and signaling), and by extracellular matrix stiffness sensed at integrin focal adhesions or thanks to mechanosensitive ion channels, leading to modulation of the migration, depending on ECM properties.
Different kinds of nanofibers have been made up to reproduce individually or in association, different physical and chemical parameters found in vivo.
During cancer the alignment of the ECM fibers has been extensively described as modified by the tumor growth itself, the ECM remodeling by cancer cells and the imbalance between ECM protein production, degradation, and crosslinking. All those events are leading to the creation of a tumoral microenvironment promoting cell migration, called desmoplastic environment, and presenting ECM protein composition changes, fibers alignment and stiffness increase. When cancer (and healthy) cells are cultivated on desmoplastic-like nanofibers configuration, the cells migrate along the nanofibers and the migration speed is increased [
19]. On the contrary on non-aligned nanofibers the cells migrate along all directions and the translocation takes place over a short distance.
The ECM composition and protein abundance have a profound impact on cells behavior and migration as well. ECM cells receptor expression is co-regulated with ECM changes observed in physiological and pathological context, and different ligand/integrins combinations are deeply changing the traction forces exerted by the cells, the adhesion formation and the following mechanosignaling [
124]. Adhesion force must therefore be neither too strong nor too weak, to optimize and adapt cell migration within the microenvironment. In the case of ECM protein low abundance, or ligand/integrins combination not corresponding, cells are adapting their migrating behavior. In the publication of Saleh et al, the behavior of glioma stem cells expressing mainly collagen receptor, was compared while migrating on in vitro laminin coated nanofibers environment and after glioma stem cells xenograft into mouse brain (collagen is not abundantly naturally expressed in brain) [
47]. Then GSCs appeared as migrating collectively to escapes anoikis (death by cell detachment of ECM matrix), both on nanofibers and mouse brain. l. Consequently, coating of nanofibers with proteins is greatly affecting cell behavior and migration, modulating migration behavior both in vitro and in vivo [
25,
125]. Also, gradient of bioactive agents can guide migration, thanks to chemotactism, with cells preferring to migrate along the gradient towards higher ECM protein concentrations. The dependence on ECM protein or other bioactive agent for migration is shown as well by performing competition between a BSA gradient and a bioactive agent deposited on the less concentrated by electrospray, within microfluidic device or by electro hydrodynamic printing [
126].
Mechanical cues as stiffness have been observed many times as influencing migration, both in 2D and 3D, and occur as well during cell migration on nanofibers with different stiffnesses. Marhuenda et al. [
19] used PAN nanofibres stabilized at 250°C for two hours, with stiffnesses modulations to study glioma stem cell migration, in a 3D fibrillary environment depending on rigidity. They modified the stiffness of nanofibers by adding multiwalled carbon nanotubes (MWCNTs) in the polymeric solution before electrospinning, which modified the intrinsic young’s module of PAN fibers. They have obtained and selected electrospun fibres stiffness ranges from 3 to 1260 kPa, which are values reported for human healthy tissues and gliomas [
127]. It appears that the amount of MWCNTs is independent of fibers diameter, and 166 kPa stiffness fibers was found as optimal for the glioma stern cell migration, increasing migration rate by ~4 [
19]. These values around 100kPa have been described previously as well as optimum for migration as well by Bangasser et al.[
128]. Also, between 3 and 1260kPa, can be found a range of stiffness that can be used for other cell subtype in order to make cell culture in a relevant environment in terms of stiffness [
129].
3.4.2. Cancer research
Whereas 2D scaffolds for cancer study are routinely used, it is well known that the results obtained are far from reality and can lead to artefact. Cancer tissue engineering in 3D nanofibers scaffolds better mimics the reality than 2D scaffolds [
130] and focus is currently on reducing animal model thanks to in vitro pertinent 3D matrices modelling cancer microenvironment. These scaffolds are used to study drugs delivery, to isolate CTCs, to study modifications of cells behavior due to chemical or physical changes of the environment. One of the differences between 2D and 3D scaffolds is the access to nutrients. In 2D scaffolds, nutrients are uniformly spread while spatial gradient is observed in vivo, especially in for cancer cells due to the rigidification of the tumorous environment [
45].
Nanofibers materials are produced with properties mimicking as closely as possible to the ones found in tumors environment and aim to reproduce ECM interactions when cultivated on fibers. It is well known that cancer cells proliferation and migration are impacted by ECM’s stiffness and ECM composition, [
131,
132,
133] as well as the tumor grade, aggressivity and drug resistance. Chitosan/poly (ethylene oxide) nanofibers scaffold has showed remarkable results as well. When MCF-7 breast cancer cells were seeded on it, 3D breast cancer tissues were formed after 10 days with higher proliferation rate than what observed in conventional 2D adherent plates [
134].
In another study, Saha et al. produced PCL electrospun scaffolds with either aligned or non-aligned fibers. The MCF-7 cells seeded on them shown morphologies different in the two environments (elongated shape and flat stellar shape respectively) highlighting topography of the fibers has having a great impact on tumor cells behavior [
135]. Ricci and al. showed that PDAC cells (pancreatic ductal adenocarcinoma) had different behavior depending on their seeding on nanofibers scaffolds or sponge scaffold. In the case of PDAC, spongy scaffold seems to increase proliferation compared to fibrous scaffold. The secretion of matrix metalloproteinase (MMP) appeared as changing regarding the material composition of the sponges (poly (vinyl alcohol)/gelatin (PVA/G) mixture and poly (ethylene oxide terephthalate)/poly (butylene terephthalate) (PEOT/PBT) copolymer but was secreted in both sponges and fibers [
136]. Kim et al. were able to coculture BM-DC (bone marrow dendritic cells) and CT26 (colon cancer cells) and reproduce the crosstalk in vivo happening in between those cells. BM-DC chosen as immune cell model and presenting antigens to T cells, could swallow up mitoxantrone-treated CT26 cancer cells as it would have been the case in vivo. Those coculture could then provide wonderful in vitro model of engulfment of cancer cells by T cells [
137]. Jain et al proved that glioblastoma cells (U87) migration was promoted on aligned fibers scaffolds [
138]. This enhancement of migration could be used to guide glioblastoma cells away from the primary tumor trap thanks to topo induction and attract them in an extracortical trap where it would be more accessible and thus enable an efficient operation.
Primary culture of human glioma stem cell (GSC) when deposited on poly acrylonitrile nanofibers (PAN) by A. Saleh and E. Marhuenda et al., appeared as capable of modulating their migrating behavior. Those migrations modulations, individual or collective, were depending on the presence of laminin coating on the surface, of the ECM receptors expression of the GSC, and were recapitulating the migration behavior observed in vivo during xenograft of those same GSCs. As well the transcriptomic assay performed in 3D compared to classic 2D exhibit 98 genes deregulated implicated into cell cycle, proliferation and kinesin family suggesting a shift to an aggressive and invasive phenotype [
47].
E. Marhuenda et al. investigated the migration of GSCs deposited on 3D PAN nanofibers, depending on the microenvironment stiffness. The stiffness of the nanofibers has been tuned through the addition of MWCNTs, from 6 to 1260kPa. The GSCs were found to migrate 4 times more at 166kPa than in the other stiffnesses and were associated with higher invasiveness markers. This exhibits the existence of optimal stiffness for migration within 3D nanofibers mats, and even appeared as able to trigger migration by itself in proliferation conditions. This optimal stiffness is very likely depending on cell type [
19].
Another possibility to use nanofibers is immunosensing for cancer screening. It is a way to detect tumor markers or circulating tumor cells in blood at an early stage of cancer development [
25]. By functionalizing nanofibers with bioactive molecules (such as enzymes, antibodies), specific cells can recognize it and adhere. Ali et al. created a zinc oxide electrospun nanofibers scaffold decorated with EGFR-2 allowing detection of breast cancer biomarker for early diagnostics. This system, based on electrochemical impedance technique, detects 1Fm concentration fast [
139].
Another example is a scaffold made of ZnO nanofibers containing MWCNTs and conjugated with the anti-carcinoma antigen-125 antibody, carcinoma antigen-125 is a specific marker for ovarian cancer [
140]. Similarly, an oxygen sensor was created by combining PCL nanofibers with oxygen-sensitive ruthenium [
141].
The capture of CTCs could allow to slow down and prevent metastasis, as well as obtaining information to better diagnose cancer and analyses the effectiveness of drugs. CTCs (HeLa, KB, A549, and MCF-7 cells) were specifically captured in a microfluidic chamber by PLGA nanofiber arrays coated with hyaluronic acid (CD44 receptors for hyaluronic acid are overexpressed in many cancers) in the study of G. Xu et al. [
142]. The HeLa captured cells continued to grow on the nanofibrous membranes in the micro-fluidic chip without compromising cell viability making it promising for individualized medicine research. By capturing CTCs, drugs could be assessed and monitored in real time.
pH plays a central role in many biological processes and particularly in cancer. To quantify and perceive this biological parameter, organic hybrid electrospun nanofibers have been filled with pH sensing capsules. They changed optically when submitted to pro-ton-induced switching. This change was analyzed with fluorescence detectors and led to quantify of local proton concentration. It would be interesting to use this kind of pH sensing electrospun fibers to measure in vivo, both spatially and temporally, the extra-cellular pH to study glycolysis (inhibiting anti-cancer drugs) [
143].
3.4.5. Tissue engineering
A scaffold for tissue engineering is a structure made to facilitate growth, proliferation, and differentiation of cells, works as a framework for tissue formation and can be implanted into a patient. The creation of tissue by seeding cells on electrospun nanofibers has already been evaluated for bone regeneration, neuroscience, and skin reconstruction.
For tissue regeneration, growth factors are required but are unstable and have a short half-life. Their incorporation into nanofibers would allow them to maintain their activity and to stabilize them. Promising results have been obtained with fibroblast (FGF), epidermal (EGF), transforming (TGF), neural (NGF), platelet (PDGF), connective tissue (CTGF), vascular endothelial (VEGF) growth factors [
148]. Qu et al (2019) encapsulated BSA and transforming growth factors (TGF B3) in PCL/PLGA nanofibers. This matrix could then induce the differentiation of synovium stem cells into fibrocartilage tissue [
149].
The creation of Shape Memory Polymer (SMP) nanofibers is interesting for tissue engineering specifically to minimize invasive surgery [
150] and magnetic nanofibers is also of interest as, magnetic stimulation allows the alignment of cells on a magnetic matrix [
151].
Wieringa et al. were able to show the effect of synergistic action of different peptides (P20 and RGD among others) on neurite and glia growth [
152]. This is illustrating the interest in functionalizing heterogeneous scaffolds allowing to study cell behavior in more accurate models of the ECM and better understand the complexity of the biological system in which cells evolve.
Nanofibers scaffold offers a more optimized environment than other 3D cell culture system for cell attachment, osteoblastic differentiation, mineralization, and better bone regeneration [
61]. Electrospinning allows to customize scaffold to provide them the appropriate mechanical properties wanted and high porosity [
153]. Wang et al. for example used PLLA solution incorporated with PHBV to be electrospun for bone tissue engineering. The combination of those two polymers were offering shape memory property and good mechanical properties respectively [
154]. Another study presented PAN/nCB/HA electrospun nanofiber, an excellent candidate for bone and other hard tissue engineering. HA was used to better mimic natural bone environment and nCB (carbon black nanoparticle) improved mechanical properties of PAN/HA scaffold. The full combination enhanced MC3T3-E1 osteoblast cells proliferation and adhesion [
155].
To promote regeneration of tissues, matrices often combine a biocompatible polymer with an inorganic phase [
25]. Matrix of PLA, PCL and PEO fibers contains large, interconnected pores and has been shown to allow osteogenic differentiation of MSCs. The addition of minerals and bioactive agents enhance the ability of the scaffold to promote differentiation.
Some biomolecules can be added to promote cell activation and cell growth. For example, Rachmiel et al. had electro-spun a solution of PCL and hyaluronic acid (HA) which led to enhance osteogenic differentiation. More recently, PA6/CS electro-spun scaffold was obtained and functionalized with HA particles. PA6 is mimicking collagen and biodegradation rate of CS, present in ECM, is quick enough to ensure new bone formation. Finally, HA, which was mineralized, enhancing MC3T3-E1 cell attachment and proliferation. All these results make it a promising candidate for bone tissue engineering. The functionalization of PCL electrospun nanofibers with E7 and BMP-2, two mimetic peptides found in native bone ECM, promoted BM-MSC adhesion and osteogenic differentiation. Also, it was shown that PAN nanofibers scaffold, with Ag particles, allows osteoblasts to survive and proliferate. Ag biocompatibility, antibacterial property, and ability to be sterilized make it a suitable candidate for a prosthesis with double function (one side for bone regeneration and the other side for soft tissue repair).
Plant extracts, essential oils and other phytoconstituents (such as Lemongrass, Baicalein, or cinnamon) have been used to treat diseases, for their properties helping the reparation and/or regeneration hard tissues for many centuries [
156]. Electrospinning of these constituents allows exploiting their potential. For example, Panax ginseng incorporated in PCL nanofibers improved proliferation of mesenchymal stem cells and induced osteogenic gene expression [
156]. Curcumin is also known for its benefits in bone regeneration.
One main property of bone tissue is piezoelectricity because of collagen micelles [
153], inducing bone growth and regeneration. Kitsara et al. produced a scaffold made of PVDF electrospun nanofibers treated with oxygen plasma. Voltage-gated calcium channels were stimulated, then promoting cells activation [
154]. Carbon nanofiber matrices, made by electrospinning PAN followed by calcination and carbonization, showed a promising result for the stimulation of bone tissue regeneration by applying an electric current as well. MG-63 cells were cultivated onto those matrices and an electric current was sent, concentrating into the highly conductive CNFs. The stimulation of the cells through the CNFs activating their voltage gated sodium channels changing the transmembrane potential of the MG-63 cells. This electrical stimulation of cell promoted proliferation and the ALP activity (alkaline phosphatase) of bone cells [
157]. The same group showed the functionalization of those matrices with hydroxyapatite crystals was promoting cell growth and differentiation of bone cells as well. These bio ceramics were mimicking the mechanical properties of the bone, were acting as a reservoir of calcium and phosphate, and was promoting osteoconduction as well as osteoinduction [
157].
Finally, the topographic structure is an essential factor to study [
153]. For example, Xu et al. [
158] produced a scaffold by electrospinning PLA and Chitosan and by modifying the temperature of the jets, they could form chitosan islands structure at the surface that then offer a roughness and a balance between hydrophilicity and hydrophobicity for cell adhesion and recognition site. A high degree of roughness favors the expression of osteogenic genes while a low degree of roughness favors the chondro-genic differentiation of mesenchymal stromal cells [
159].
In the context for neural tissue engineering, nanofibers scaffolds are improving nerve regeneration [
61].
Spinal cord, nerve, and brain injury as well as neurodegenerative diseases are characterized by alteration of the architecture of the tissue leading to growth inhibition and axon guidance as well as glial scar [
160]. Neural tissue engineering is important since it is difficult to find donors for the treatment of peripheral nerve injuries [
60]. Electrospinning offers the possibility to build scaffolds with mechanical and biochemical properties inducing differentiation of neural stem cells [
161]. Lu-Chen et al. showed an electrospun POMA (poly(o-methoxy aniline)) fiber matrix allowing neural stem cells (NSCs) to grow and that could be used for neuroscience research and tissue creation [
45]. In another study, Jenab et al. produced a scaffold by electrospinning a solution of PAN and Kefiran (a polysaccharide produced by microorganisms) [
162]. They showed an enhancement of PC12 cells viability and improvement of differentiation making it a promising candidate for neural stem cell culture and spinal cord repairing. This scaffold showed anti-cancerous properties, inhibiting MCF-7 cells growth, and promoted PBMC cells growth. More recently, PCL/PGS electrospun fibers filled with HA particles were studied. This scaffold, while enhancing cell viability and adhesion, provides appropriate properties for nerve tissue engineering [
163]. Xue et al. investigated the impact of alignment, diameter, and surface properties of electrospun PCL fibers on BMSC differentiation into Schwann cells [
164]. The alignment of fibers thick enough was promoting the differentiation of BMSCs into Schwann cells and determines the alignment of these cells. The topo induction effect of this alignment appears as a promising method to act on the organization of the axon network helping axon guidance for tissue engineering.
Addition of bioactive molecules can enhance regeneration. In the same study from Xue et al., the surface coating with laminin improves the maturation and secretion of neurotrophin from Schwann cells. Those secretions help to guide and enhance the neurite extension of PC12 and DRG cells co-seeded with Schwann cells [
164]. It is possible as well to produce matrices com-posed with different layers with varied compositions. To obtain a system with controlled distribution of PDGF, BDNF and NT-3, three layers of nanofibers were synthetized: one layer of aligned PCL nanofibers and two layers of PGLA [
165]. The two layers of PGLA had a different concentration to allow a sequential release of growth factors. The PCL layer helped cell attachment and collagen type II production Similarly, Pan et al. encapsulated insulin growth factors (IGF 1) and brain-derived neurotrophic factors (BDNF) in graphene oxide and PLGA nanofibers [
166]. The in vitro results showed the protective ability of neural stem cells from H202-induced oxidative stress. The animal model for spinal cord injury showed an increase in the number of neurons at the lesion site and functional recovery, highlighting an improvement in nerve regeneration. Recently, Ni nanoparticles were added to PAN/PANI electrospun nanofibers to enhance conductivity and hydrophilicity of the scaffold. Thanks to this addition, Schwann cells proliferation rate was increased (2.1 times) under electrical stimulation, which revealing potential to accelerate nerve healing. Electrical conductivity is essential to ensure nerve repair and it can be modulated by the presence of Ni nanoparticles [
167].
The addition of electrically conductive nanoparticles, such as CNT, electrical stimulation can be done and promote axon growth and differentiation into neurons [
60]. PPy-Gr/PVA nanofibers thanks to good conductivity enhanced cell length and anti-aging effects on PC12 neuroplastic cells from adrenal gland under electrical stimulation [
168]. In another study, PCL nanofibers coated with PPy form shell-sheath nanofibers and electrical stimulation, promotes neurite extension both on aligned and non-aligned nanofibers [
169]. Neurites extension from PC12 cells as well as the growth of Schwann cells can be promoted as well by electrical stimulation and growth factors when cultivated on PANi, PLCL and silk fibroin nanofibers containing nerve growth factors [
170].
To better mimic the spatial structure of the ECM in the nervous system, multitubular conduits should be favored. Artificial channels can be introduced into the nerve conduit to construct an artificial multichannel nerve tract, helping axon guidance and growth in the context of nerve injury. For example, PTFE rods and sucrose fibers have been used to produce channels of con-trolled sizes by removing the matrices or dissolving the sucrose fibers after structuring the artificial “nerve conduits”. Huang et al. developed a matrix composed of an electrospun porous PCL sheath surrounding an oriented collagen/chitosan multichannel filler material to promote nerve regeneration. The filler material is obtained by a directional freezing technique using liquid nitrogen and the PCL shell by electrospinning on a steel rod to obtain a hollow tubular sheath. In vitro and in vivo studies have shown this matrix as promoting axon regeneration and stem cell migration. The results show this matrix has had the same long-term effects as autografts.
Hsu et al. fabricated a fibrous BSA matrix doped with hemin. The doping was increasing the adsorption of laminin on the fibers, essential for cell attachment, and was maintaining the coating. The hemin doping was improving the attachment and viability of hiPSC-derived NSCs. Also, on those matrixes the differentiation and proliferation were promoted thanks to the delivery of the growth factor FGF2 by the matrix. By applying electrical stimulation through the scaffold, it has resulted in neurite branch-es formation and enhanced differentiation.
As said in the introduction of this part, SPM can be created via electrospinning. It has been studied a lot for tissue engineering to prevent invasive surgery. For instance, Wang et al. produced a SPM scaffold that takes the form of nerve conduit only when implanted into the body. It was initially a planar 3D scaffold to allow a better cell loading and, when implanted in the body of rats, the temperature triggered the formation of tubular conduit (
Figure 7) [
171].
Vascular tissue engineering [
60]
Electrospinning enables to obtain a controlled scaffold with an alignment that mimics the organization of smooth muscle cells and endothelial cells. One of the current strategies for integrating an artificial vascular network into organs and tissue engineered construct but it remains challenging, and many parameters must be additionally considered. The blood vessels are com-posed by three layers with different functions: the intima, the media and the advantia with a layer of endothelial cells lining the blood vessels, regulating exchanges between blood stream tissues. Many vascular matrices have been produced so far. Among them, a tubular structure with a multi-layered wall mimicking multi-layered blood vessel. Also, Yu et al. produced a bilayer vascular graft with an inner layer composed of aligned TPU/SF fibers and a random outer layer composed of the same fibres.
To promote the endothelial formation and modulate endothelial cell proliferation by separately activating or deactivating the expression of specific genes, growth factors have been incorporated into the nanofibers and targeted delivery systems have been developed to deliver miRNAs locally. Tubular matrices with a degradation rate proportional to the rate of tissue remodeling have been produced to promote rapid and efficient endothelialization. PCL and polydioxanone matrices were tested in vivo in rats and the degradation of polydioxane provided sufficient space for cell infiltration. Vascular smooth muscle regeneration appeared improved. Another tubular scaffold made of SF electrospun fibers was implanted in mouse abdominal aorta and the authors could observe growth and regeneration of vascular smooth muscle as well. Liu et al. produced a sulphated SF electrospun scaffold and showed an enhancement of the adhesion and proliferation of endothelial and smooth muscle cells while promoting anticoagulation properties. However, really few electrospun scaffold is currently used as a specific vascularized organ model in vitro.
Cartilage tissue engineering is challenging since the organisation of cartilage tissue is complex, and the chondrocytes properties differ with the region as well as the ECM composition [
60]. A matrix based on gelatin and PLA nanofibers, in which hyaluronic acid was incorporated, making possible to repair a cartilage defect in rat model [
172]. This porous matrix has compressive strength, superabsorbent and shape recovery properties and hyaluronic acid is a recognition site for cells being a major element of the cartilage ECM.
Tendon and ligament tissues engineering appear as promising for injury repair, as tendons have poor healing capacities. Collagen fiber bundles are easily reproducible by electrospinning nanofibers. By coating nanofibers with a gradient of platelet-derived growth factor, tenocytes markers expression was enhanced, indicating a better tenocytes differentiation from the AD-SCs [
173]. The alignment of the nanofibers plays a significant role in tenocyte differentiation, as well as stiffness [
173,
174,
175,
176].
HDAC suppression plays a key role in enhancing tenogenesis on an aligned topography. Zhang et al. [
176] investigated the impact of incorporating epigenetic bioactive TSA compound (HDAC inhibitor) into an aligned PLLA nanofiber for tendon regeneration. The release of TSA follows three steps: an abrupt release, one slowing down gradually, and finally a constant release. After 72h of incubation, the amount of TSA released was higher for the unaligned fibers. The aligned nanofibers containing TSA were having an additive effect on promoting tendon regeneration. The presence of TSA allowed the formation of larger collagen fibrils and a bimodal distribution of the collagen diameter, as it can be found in natural tendon.
Among all the matrices realized, the matrix structured with honeycombs presents the highest viability of cardiomyocytes, the deepest cellular penetration and the highest expression of genes related to the heart.
Commonly, the fibers scaffold used for cardiac engineering are either made of natural polymer, or synthetic ones like PLA (polylactic acid), polylactic-co-glycolide (PLGA), or polycaprolactone (PCL). PGS-PCL fibers functionalized with vascular endothelial growth factor (VEGF) [
177] and construct with aligned and electroconductive fibers made from gelatin, PLGA and polypyrrole [
178], have been used to create cardiac patch, as well as PLGA fibers coated with adhesive peptides [
179].
When the surface of matrices is structured, it promotes specific stem cell differentiation and maturation as observe for iPSC cells derived cardiomyocytes during cell culture on a monolayer of gelatin nanofibers with honeycomb compartments [
180]. As well, thanks to electrical polarization can be incorporated to regulate differentiation. Cardiovascular disease-specific iPSCs were seeded onto aligned PANi and polyetersulfone nanofibers. By applying electrical pulses to mimic the simulation found in the heart, the iPSCs differentiated into cardiomyocytes [
181].
Helical, coiled, or spring-like fibers have been studied as well, as better representing the coiled perimysial fibers within the heart walls and helping contraction [
182].
Those coiled fiber arrays containing gold nanoparticles allowed organized cell growth along the fibers and strong actinin striation promoting strong contraction force and high contraction rate [
182].
Multilayered matrix has been developed as well for cardiac tissue engineering [
183]. A first grooved layer was created to promote the organization of cells into contractable tissue, a second layer with cages and channels was added to organize endothelial cells into vasculatures, and a third cage-like layer was designed to encapsulate dexamethasone contained in PLGA microparticles to release this anti-inflammatory molecule in a controlled manner. These three layers were prepared separately and then embedded in a biological ECM glue to form a 3D vascularized heart tissue prior to in vivo transplantation. After implantation in rats, blood vessels containing blood cells were able to infiltrate the matrix.
More recently, a PCL/Ge/PAni scaffold was produced by electrospinning and allowed cell proliferation while preserving cardiomyocytes. Modulation of the electrophysiological properties of cardiomyocytes was possible due to the presence of PAni. This scaffold is thus an appropriate candidate for cardiac tissue engineering [
184].
For the regeneration of tissues such as the ureter, trachea or other, the use of electrospun nanofiber matrices could be considered [
25].
PLCL nanofiber incorporating ethylene diamine tetra acetic acid and sodium cholate were used to coat metal stents [
185]. This has allowed to inhibit biliary tract occlusions. So far, only a few polyurethane nanofiber matrices have been assessed for the bile duct.
The ureter is easily infected and obstructed after surgery [
186]. A matrix of PCL and PLGA nanofibers ureteral stent was inserted into pig ureter to evaluate how they can prevent obstructions compared to the commercial stent. They show better biocompatibility than the commercial polyurethane stent and did not induce obstruction.
Finally, preliminary studies have been conducted to regenerate the trachea [
187]. A bilayer matrix of PLCL and collagen nanofibers (a porous layer on the outside and a dense layer on the inside) was constructed. Tracheal epithelial cells and chondrocytes were seeded separately in the inner and outer layer and then packed in a rat tracheal strip. They resulted in improved epithelial production, cartilage maturation, and capillary neogenesis after implantation into the rat trachea.
3.4.6. Drug delivery
Electrospun fibers are great candidates for drug delivery. They present a high surface area to volume ratio and can allow local drug delivery [
61]. This method reduces drug toxicity and increases therapeutic efficacy by prolongating the dissolution rate of the drugs and make continuous drug release. It can be used to manipulate cancer cell migration and locally control the release of anti-tumors that can be loaded in fibers since they are porous structures.
Different strategies can be employed.
First, drug can be mixed in polymer solution before electrospinning [
61,
153]. By loading anti-drug cancer within the fibers, instability, and adverse effects on surrounding healthy tissues are reduced and local concentration in tumor sites is increased [
61]. Liu et al developed doxorubicin hydrochloride loaded in electrospun PLLA nanofibers system to treat locally liver cancer and prevent post-surgery metastasis. The drug was entirely diffused from the system [
61,
62]. Curcumin was incorporated in PLLA/PHB solution before electrospinning. In vitro studies showed that it was released for 14 days and improved osteogenic differentiation of human adipose-derived stem cells. In another study, an RNAi and polyethylenimine plasmid (to specifically suppress matrix met-alloproteinase-2 expression) and paclitaxel (a cytotoxic drug) were encapsulated in a PLGA nanofiber matrix to release both agents and thereby inhibit invasion, angiogenesis, growth, and cell proliferation [
188].
The main issue for such an application is about the release and degradation rate who need to be deeply investigated to control drug release (by diffusion or diffusion and degradation of the scaffold). To prevent an initial burst release, one strategy is to incorporate a nanocarrier into the fibres [
61,
153]. For example, Jonah et al. [
189] generated a superhydrophobic electrospun nanofiber mesh to slow down the delivery of the encapsulated lipophilic anticancer agent, 7-ethyl-10-hydroxycamptothecin. In vitro results and results from the in vivo mouse model of lung cancer suggest that this system provides controlled and specific delivery to treat glioblastoma and prevent locoregional recurrence.
Drugs can also be immobilized on electrospun fibers surfaces chemically or physically [
61]. Thus, immobilization prevents drug exposure to harsh solvent or to high voltage that can denature or deactivate it. It also facilitates the process since usually drugs have high molecular weight and/or charges on their surfaces that make it more difficult to dissolve and electrospun. To optimize the drugs immobilization, fibers surfaces are first treated chemically (addition of functional groups such as hydroxyl groups). Chemical functionalization allows the control of the amount of drug immobilized and reduces initial burst release. Im and al. reduced an initial burst release by fluorinated cross-linked hydrogel fibers before adding the drug [
61]. Also, a bandage was developed from electrospun PAN nanofibers in which Munaweera et al. [
190] incorporated holmium-166 to cure skin cancer with-out affecting healthy cells.
Another strategy is coaxial electrospinning. The polymer shell would then protect the core filled with biomolecules [
61]. For example, nanogels sensible to redox reaction were incorporated into the outer shell of the coaxial nanofibers containing BMP-2. When desulphated bonds of nanogel were modified by GSH concentration, BMP-2 was then released [
191].
Also, to have a multidrug system delivery, multilayer stacked nanofibers can be produced. For example, Okuda and al. produced tetra-layered nanofiber system to have dual release: the first and third layers were drug-loaded while the second and the fourth were barrier meshes. They were able to have dual release in time by modifying barrier meshes (such as thickness) [
61].
Smart polymers enable an on-demand drug delivery. For example, Kim and al. [
192] electrospun a solution composed of a chemically cross linkable temperature-responsive polymer, magnetic nanoparticles, and doxorubicin to target skin cancer cells. When the nanofibers were submitted to magnetic field, the nanoparticles produced heat that led to the deswelling of polymers and thus the drug release. Also, lauric and stearic acids are phase change materials (PCM) with a melting point of 39°C [
193]. Therefore, they can be used for controlled drug release by photo thermal heating. Xue et al. [
193] formed lipoproteins from these acids to encapsulate NGFs. These microparticles were then electrosprayed between two layers of electrospun PCL nanofibers. Nerve growth factors, released in a controlled manner, stimulated the PC12 growth of neurites into spheroids. Another strategy is to use pH stimulation. Cancer environment is known to have a rather acid pH (6.8). Thus, Zhao and al. [
194] produced PLA nanofibers containing drug-loaded silica nanoparticles functionalized with CaCO3. (
Figure 8) When environment was acid, the physiological pH was reduced and CaCO3 dissolved which allowed drug release.
Finally, there is the possibility to electrospun nanofibers for siRNA delivery to target specific cells [
61]. Achille and al. [
195] load-ed bioactive plasmid encoding for shRNA against Cdk2 into nanofibers. While fibers were degraded, plasmid DNA was released over 21 days. This prevented MCF-7 proliferation and decreased their viability.
3.4.7. Wound healing
To protect the wound, remove exudate and inhibit microorganisms, dressings are necessary. Pores, large air surface and stimulation of fibroblast cells are the advantages of dressings made from electrospun nanofibers. Treatment factors such as antibacterial factors, can be included in the matrix [
45].
The introduction of natural extracts into the nanofibers makes it possible to enhance wound reduction without synthetic compounds. Natural compounds, such as plant-based extract or some phytoconstituents (Curcumin, Lemongrass) as said before, promote wound healing in distinct stages of the process. They prevent coagulation, inflammation, and induce re-epithelialization [
156]. However, by only applying them on the wound, some inconvenience appears such as drying or softening the surrounding tissue. Consequently, introducing these components within electrospun scaffold is a promising alternative [
156]. Aloe Vera has antioxidant properties, induces synthesis of collagen, hyaluronic acid and dermatan sulphate, essential components of the ECM, and promotes cell proliferation and migration [
148]. Garcia-Orue et al. incorporated Aloe Vera and epidermal growth factors into PLGA nanofibers [
196]. Fibroblast proliferation was stimulated, and the in vivo study showed a significantly increase in wound healing. Apitherapy is a potential target for wound healing as well. Synthesis of honey/PVA/chitosan and propolis nanofibers by electrospinning has antibacterial properties and promoted wound healing. Another study, on Waster rats, highlights the effects of Garcinia mangostana acetone extract, added into chitosan and poly (vinyl alcohol) polymer before electrospinning. It inhibits microbial colonization but also increase wound healing process [
156].
Some polymers exhibit antibacterial properties. Among other materials, PAN nanofibers are one of them and their physiological mechanical properties make them a promising candidate for wound healing. Antibacterial activity against S. aureus have been seen as well in Cu/PAN nanofibers [
45]. A patent, filed in 2019, defends the antifungal activity of microfibers made from PAN nanofibers. These are sprayed onto a TEFLON® plate and air-dried, then rinsed with acetone before being randomly stuck together in DMF [
197]. Another example is presented in Ibrahim et al. work [
198]. CMCS/PVA nanofibers containing gold nanoparticles (AuNP) were prepared by electrospinning and they showed the antibacterial activity of gold nanoparticles against Gram negative and positives bacteria were higher when encapsulated in the nanofibers than when they were alone and were non cytotoxic on A-549 cells. More recently, PCL-g-PAA electrospun nanofibers combined with GO-g-PTA nanosheets were studied for chronic wound care. The combination of the nanofibers absorbing body fluid and nanosheet’s antibacterial properties enhances cell proliferation and wound healing process [
199]. Quercetin is another natural compound presenting antioxidant, antiallergic, anticancer, antibacterial, and antifungal properties. It has been incorporated in PCL electrospun nanofibers and inhibited the formation of C. albicans biofilm [
155].
Preventing scar formation is challenging, especially for deep burn victims. To prevent it, molecules, such as inhibitors of transforming growths factor-β1, implicated into fibroblast proliferation deregulation, can be incorporated into the nanofibers to reduce scar formation [
200]. By promoting early wound healing with ginsenoside-Rg3 added into PLGA fibers, the formation of hypertrophic scars at an advanced stage was prevented as well [
201].
Diabetes might cause impaired repair mechanism and wound healing process [
202]. To help wound healing, stimulation of collagen formation, re-epithelialization, vascularization, and inhibition of inflammatory reaction can be promoted by controlling the release of dimethyloxalylglycine that were loaded in aligned PLA nanofibers, improving wound healing of patients with diabetes [
99].
Angiogenesis is required for both maintaining the survival of the new tissue as well as its growth. Chen et al. produced a PCL nanofibers scaffold with B and Co co-doped bioactive glass nanoparticles. The scaffold was not cytotoxic to bone marrow stromal cells ST-2 and their secretion of vascular endothelial growth factors was enhanced, and thus angiogenesis [
203].
Finally, bifunctional matrices have shown great promise in healing tumor injury while preventing tumor recurrence. The addition of Cu2S into PLA and PCL nanofibers resulted in increased skin tumor cell mortality, tumor growth inhibition after photothermal heating, while promoting proliferation and migration of healthy skin cells to heal the wound [
204].