Collaboration in Contradiction: Self-Adaptive Synergistic ROS Generation and Scavenge Balancing Strategies Used for the Infected Wounds Treatment

The rational utilization of ROS is key to treating infected wounds. Exogenous ROS can destroy bacterial structures, quickly kill bacteria, and inhibit secondary infections. However, excess ROS at the wound will cause a secondary inflammatory response. Acute infections exacerbate this damage by increasing endogenous ROS, complicating the maintenance of ROS homeostasis. Therefore, regulating the balance of ROS production and scavenging in wounds has emerged as a promising strategy for wound treatment. Conventional ROS balancing platforms are mostly based on the " all for one" strategy of functional superposition and lack self-adaptability and integration. To subvert this conventional strategy, this study proposes a "one for all" self-adaptive integrated photodynamic therapy (PDT)-antioxidant model to actively regulate the ROS balance. A gelatin-hyaluronic acid hydrogel embedded with Se-modified cerium dioxide nanoparticles (Gel-HA-Se@CeO2 NPs) is designed for treating infected wounds. The Se@CeO2 NPs serve both as nanoenzymes and photosensitizers(PS). As nanoenzymes, they exhibit catalase and superoxide dismutase activities, converting hydrogen peroxide and superoxide anions into oxygen. As a PS, it synergizes with oxygen under NIR irradiation to rapidly produce singlet oxygen. Additionally, Se modification enhances the PDT effects by disrupting bacterial antioxidant systems. In vitro and in vivo experiments revealed that the ROS balance platform polarizes M1-type macrophages to M2-type macrophages, altering the wound microenvironment from proinflammatory to prohealing. RNA sequencing revealed that this hydrogel accelerated the reconstruction of the vascular network of the wound by activating the PI3K/AKT pathway and increasing VEGF secretion.This strategy is believed to be beneficial not only for infected wounds but also for treating other conditions that involve the regulation of reactive oxygen species, such as tumors and bacterial infections.