Clinical applications of a novel, Food and Drug Administration -approved biomimetic matrix in refractory diabetic foot ulcers: An observational case series analysis

Background: Biomimetic matrix (BMM) is a fully synthetic matrix composed of self-assembling peptides, an emerging class of biomaterials, for the treatment of chronic wounds. Aim: This preliminary case series explores the potential clinical applications of BMM in eight patients with chronic diabetic foot ulcers. The patients were selected based on wound chronicity and a lack of response to standard of care and/or previous treatments with biologics, including amniotic-derived materials, decellularized collagen, and living cell/collagen-derived products. Results: A total of eight subjects were evaluated and monitored in this case series. All subjects had diabetes, and the comorbidities included venous stasis, Charcot neuroarthropathy, obesity, osteomyelitis, peripheral vascular disease, and a history of prior partial foot amputation. All subjects treated with BMM responded after one to three applications. Overall, treatment with BMM resulted in an average percent wound area reduction of 63.6% over 6 weeks for chronic wounds that had remained open for an average of 21.5 months. Conclusion: BMM treatment reduced the wound area and depth of complex, stalled chronic diabetic lower extremity wounds. Relevance for patients: BMM, a synthetic self-assembling peptide-based matrix, demonstrated progression in treating stalled diabetic wounds that were not responsive to human- or animal-derived products.
- Darwin E, Tomic-Canic M. Healing chronic wounds: Current challenges and potential solutions. Curr Dermatol Rep. 2018;7(4):296-302. doi: 10.1007/s13671-018-0239-4
- Vecin NM, Kirsner RS. Skin substitutes as treatment for chronic wounds: Current and future directions. Front Med (Lausanne). 2023;10:1154567. doi: 10.3389/fmed.2023.1154567
- Singh AV, Chandrasekar V, Prabhu VM, et al. Sustainable bioinspired materials for regenerative medicine: Balancing toxicology, environmental impact, and ethical considerations. Biomed Mater. 2024;19(6):1-17. doi: 10.1088/1748-605X/ad85bb
- Haines LA, Rajagopal K, Ozbas B, Salick DA, Pochan DJ, Schneider JP. Light-activated hydrogel formation via the triggered folding and self-assembly of a designed peptide. J Am Chem Soc. 2005;127:17025-17029. doi: 10.1021/ja054719o
- Jafari A. Advancements in self-assembling peptides: Bridging gaps in 3D cell culture and electronic device fabrication. J Biomater Appl. 2024;38(10):1013-1035. doi: 10.1177/08853282241240139
- La Manna S, Di Natale C, Onesto V, Marasco D. Self-assembling peptides: From design to biomedical applications. Int J Mol Sci. 2021;22(23):12662. doi: 10.3390/ijms222312662
- Veiga AS, Schneider JP. Antimicrobial hydrogels for the treatment of infection. Biopolymers. 2013;100:637-644. doi: 10.1002/bip.22412
- Daphne A, Salick DJP. Design of an injectable b-hairpin peptide hydrogel that kills methicillin-resistant Staphylococcus aureus. Adv Mater. 2009;21:4120-2123. doi: 10.1002/adma.200900189
- Veiga AS, Sinthuvanich C, Gaspar D, Franquelim HG, Castanho MAR, Schneider J. Arginine-rich self-assembling peptides as potent antibacterial gels. Biomaterials. 2012;33:8907-8916. doi: 10.1016/j.biomaterials.2012.08.046
- Chandrasekar V, Panicker AJ, Dey AK, et al. Integrated approaches for immunotoxicity risk assessment: Challenges and future directions. Discov Toxicol. 2024;1:9. doi: 10.1007/s44339-024-00010-w
- Sheehan P, Jones P, Caselli A, Giurini JM, Veves A. Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12-week prospective trial. Diabetes Care. 2003;26(6):1879-1882. doi: 10.2337/diacare.26.6.1879
- Santema TB, Poyck PP, Ubbink DT. Skin grafting and tissue replacement for treating foot ulcers in people with diabetes. Cochrane Database Syst Rev. 2016;2:CD011255. doi: 10.1002/14651858.CD011255.pub2
- Zheng L, Tseomashko N, Voronova A, Vasil’kov A, Hu X, Wang X. Recent advances of collagen composite biomaterials for biomedical engineering: Antibacterial functionalization and 3D-printed architecturalization. Collagen Leather. 2024;6:22. doi: 10.1186/s42825-024-00164-8
- Wagner FW Jr. The dysvascular foot: A system for diagnosis and treatment. Foot Ankle. 1981;2(2):64-122. doi:10.1177/107110078100200202