A dual functional theranostic microneedle patch for immunomodulation and real time monitoring in diabetic wound therapy.

RATIONALE: The management of diabetic wound is limited by the absence of delivery systems that can dynamically respond to the complex pathological microenvironment. Herein, we have engineered a dual-functional theranostic microneedle (MN) patch for intelligent diabetic wound therapy.

METHODS

The patch (termed MNs@Z/CP) features a spatially designed bilayer architecture: the needle tips are loaded with a catalytic nanozyme (ZTCG) for on-demand therapy, exhibiting cascade superoxide dismutase (SOD)- and catalase (CAT)-mimetic activities to simultaneously alleviate oxidative stress and hypoxia while combating bacterial infection; the backing layer incorporates a cerium metal-organic framework (Ce-MOF)-based visual sensor for real-time monitoring of wound H2O2 levels.

RESULTS

MNs@Z/CP not only exhibited multimodal antibacterial and anti-inflammatory effects but also reprogrammed the immune microenvironment by activating the Nrf2/HO-1 pathway to shift macrophages from a pro-inflammatory (M1) to a pro-healing (M2) phenotype. In both diabetic and methicillin-resistant Staphylococcus aureus (MRSA)-infected diabetic wound models, the patch significantly accelerated wound closure, promoting angiogenesis, collagen deposition, and re-epithelialization.

CONCLUSION

This work pioneers a theranostic platform that integrates real-time diagnostic, controlled catalytic therapy, and immunomodulatory therapy, providing a viable approach to the autonomous management of chronic wounds.