Nitric oxide nanoparticles for wound healing: Future directions to overcome challenges

Chronic, nonhealing wounds inflict significant patient morbidity and mortality and impose considerable economic burdens to health care systems. This has prompted investigations of the potential wound healing therapies, and exogenous delivery of nitric oxide (NO) is one avenue that has been explored. NO is crucial for normal wound repair: it mediates many vital processes that take place after cutaneous injury and helps to ward off invading pathogens due to its inherent antimicrobial and cytostatic properties. Because of its dual wound repair and antimicrobial features, exogenous NO delivery for the acceleration of wound healing is an attractive therapeutic strategy. Several exogenous NO delivery methods have been studied, but limitations preclude their widespread clinical use. Nanotechnology can be exploited for therapeutic delivery of a variety of active ingredients including NO. A hybrid hydrogel/glass composite NO-releasing nanoparticles platform has demonstrated wound healing efficacy both in vitro and in vivo, and circumvents many of the limitations associated with other NO delivery methods. This is a promising new technology that has potential for broad clinical application owing to several advantageous features. Here, we review normal wound healing and NO's role in this process, examine the efficacy and limitations of several NO delivery methods and highlight the therapeutic potential of NO nanoparticles.