Characterization of electrospun membranes
The morphologies of aligned and random membranes were observed by SEM, as shown in Fig. 1A. The nanofibers in both groups presented smooth and continuous morphology, and the arrangement direction of the fibers in the A20 group was consistent, while that in the R20 group was disorderly. The diameters in both groups were calculated by ImageJ software. The mean diameter in the A20 group was 758 ± 102 nm, and the mean diameter in the R20 group was 730 ± 94 nm. There was no significant difference between the two groups (Additional file 1: Fig. S1). In order to investigate the mechanical properties and hydrophilicity of electrospun fiber membranes, and assess the feasibility of their later application in wound healing, mechanical properties and water contact angle were examined. Compared with the R20 group, the A20 group exhibited higher tensile strength (Fig. 1B) and elastic modulus (Fig. 1C). The water contact angle of the A20 group was significantly lower than that of the R20 group (Fig. 1D).
Previous studies have shown that the topology of biomaterials has a significant impact on subsequent cellular behaviors [24, 25]. Therefore, we sought to modulate the cytoskeletal structure of macrophages using electrospun fibrous membranes with different alignments and investigate their effects on macrophage polarization. It is generally believed that nanoscale biological scaffolds exhibit more advantages for tissue healing than micron-sized scaffolds due to their larger surface areas for the formation of more integrin adhesion sites [26]. After parameter optimization, highly aligned nanofibers were obtained. Significantly higher tensile strength and moduli of elasticity were observed in the A20 group than in the random group, which made these fibers more suitable for wound healing because they might provide more appropriate mechanical strength during tissue regeneration and reduce wound scar healing. Previous studies by Ma et al. [27] were consistent with our results, and the mechanical improvement was ascribed to the anisotropy of the aligned nanofibers. In addition, aligned nanofibers exhibited lower water contact angles than random nanofibers, indicating better hydrophilicity, which was reported to be beneficial for subsequent cell adhesion and other biological behaviors [28, 29].
Aligned nanofibers inhibited the LPS-induced M1 macrophage phenotype
To investigate the effects of aligned nanofibers on macrophage polarization, phalloidin staining was performed to observe the morphology of macrophages cultured on aligned and random nanofibers. The results showed that macrophages in the A20 group exhibited an elongated shape that extended along the fibers, while the macrophages in the other groups remained spherical (Fig. 2A). Flow cytometry showed that the proportion of M2 macrophages in the A20 group was the highest compared with that in the other two groups (Fig. 2B). Then, qPCR was performed to evaluate the expression of macrophage polarization-related genes. The A20 group had significantly upregulated expression of the M2 phenotype-related genes Arg-1, IL-4, IL-10 and TGF-β (Fig. 2C) and downregulated expression of the M1 phenotype-related genes TNF-α, IL-1β and iNOS (Fig. 2E). The ELISA results verified that the secretion of IL-4 in the A20 group was significantly higher than that in the Con and R20 groups, which was consistent with previous results (Fig. 2D). Western blotting images are shown in Fig. 2F, and the results revealed that Arg-1 expression was upregulated, while iNOS and IL-1β levels were downregulated in the A20 group. Immunofluorescence staining of CD86 and CD206 showed inhibition of M1 macrophages and promotion of M2 macrophages in the A20 group (Fig. 2G and H).
According to previous studies, the M2 macrophage phenotype usually exhibits a long spindle shape [30]. Similarly, induing macrophages to form spindle shapes with biomaterials promoted M2 polarization in macrophages [11]. It was reported that aligned electrospun nanofibers had natural advantages that prompted cells to become fusiform [31]. Thus, it might be reasonable that aligned electrospun fibers could influence the immunomodulatory functions of cells. For example, aligned electrospun microfibers allowed adipose-derived mesenchymal stem cells (ASCs) to synthesize more immunomodulatory-related factors than cells cultured on random fibers, and their conditioned medium enhanced the M2 polarization of macrophages [32]. The results of Jia et al. [20] also demonstrated that aligned nanofibers facilitated the prohealing phenotype in bone marrow-derived macrophage (BMDMs) and that aligned nanofiber-constructed nerve-guided conduits could promote peripheral nerve regeneration. However, the effect of aligned electrospun nanofibers on macrophage polarization in an inflammatory environment and the molecular mechanism remain unclear. We hypothesized that aligned nanofibers could inhibit M1 phenotype macrophage polarization under the induction of LPS. The phalloidin fluorescence images showed the morphological changes in macrophages cultured on aligned electrospun membranes. Subsequent flow cytometry, which is regarded as the gold standard, verified that the A20 group had decreased proportions of M1 macrophages and increased proportions of M2 macrophages. This finding indicated that aligned nanofibers could alter the M2/M1 ratio in an inflammatory microenvironment. Immunofluorescence staining of CD86 and CD206 also added strong evidence to this conclusion.
Arg-1 is considered a crucial marker of M2 macrophage polarization and catalyzes the hydrolysis of arginine to ornithine and urea, which are necessary for collagen production and fibrillation [8]. Arg-1 expression was significantly inhibited by LPS-induced M1 polarization, while A20 significantly promoted the expression of Arg-1. The expression of other M2 markers showed the same trend. As pleiotropic cytokines, IL-4 and IL-10 can inhibit the secretion of proinflammatory factors and play an important role in immune regulation. Transforming growth factor-β1 belongs to the TGF-β superfamily and regulates cell growth and differentiation. TGF-β1 was reported to have potential application prospects in treating wound healing and promoting cartilage and bone repair [33]. Our results showed that the expression of TGF-β1 was significantly upregulated in the A20 group, which indicated that A20 might have greater advantages in wound healing than the random nanofibers.
The expression of proinflammatory factors such as iNOS, TNF-α and IL-1β increased significantly in the M1 phenotype, but this effect was suppressed in the A20 group. TNF-α is the earliest and most important inflammatory mediator in the inflammatory response. IL-1β plays a key role in multiple inflammatory diseases. iNOS is considered a marker of M1 macrophages. iNOS is activated by inflammatory cytokine transcription, which leads to increased levels of nitric oxide (NO) during inflammatory responses [6, 34]. In general, macrophages in the A20 group showed a trend toward M2-type polarization in the presence of aligned fibers, which could reduce the expression of inflammatory factors and relieve inflammation. In addition, A20 promoted the expression of anti-inflammatory factors, which had a positive effect on later tissue repair.
Aligned nanofibers suppressed M1 polarization via the JAK-STAT and NF-κB signaling pathways
To further examine the mechanism, mRNA-seq was performed. As shown in Fig. 3A, there were 49 differentially expressed genes among the three groups. The heatmap of differentially expressed genes among the three groups is shown in Fig. 3C. When both experimental groups were compared with the Con group, the differentially expressed genes in the A20 and R20 groups were consistently upregulated or downregulated compared with those in the Con group. Therefore, only changes in gene expression between the A20 and R20 groups were subsequently analyzed. KEGG signaling pathway analysis showed that the TLR, NOD-like receptor and MAPK pathways correlated with the effects of A20 on macrophage polarization (Fig. 3B). The heatmap in Fig. 3D indicates that the expression of M1 phenotype polarization-related genes, such as STAT1 and TLR2, was significantly downregulated in the A20 group. A volcano diagram shows the same trend for STAT1 (Fig. 3E).
To further validate the RNA-seq results, Western blot analysis was performed. The results showed downregulated expression of p-NF-κB p65 in the A20 group (Fig. 3F). Immunofluorescence staining showed that the nuclear translocation of NF-κB P65 in the A20 group was significantly lower than that in the other groups (Fig. 3G). In addition, the JAK-STAT signaling pathway (p-JAK1, p-JAK2, p-STAT1 and p-STAT3) was inhibited by A20 treatment. Semiquantitative analysis showed that the difference was statistically significant (Fig. 3H).
The RNA-seq results showed that the MAPK, NOD-like receptor and TLR signaling pathways were highly associated with the difference between the A20 and R20 groups. For example, TLR2 was downregulated in the A20 group, as shown on the heatmap. It has been widely documented that the NF-κB signaling pathway, as the downstream of the TLR signaling pathway, plays an important role in macrophage polarization. In response to intracellular stimulation, such as LPS and proinflammatory cytokines, NF-κB translocates to the nucleus. In the nucleus, NF-κB binds to target genes to facilitate transcription [35]. Thus, nuclear translocation is a key part of NF-κB signaling pathway activation. The immunofluorescence staining results verified the lowest colocalization of NF-κB p65 with the nucleus in the A20 group, indicating that A20 inhibited NF-κB pathway activation.
The JAK-STAT signaling pathway is involved in numerous vital biological processes, such as cell proliferation, differentiation, apoptosis, and immune regulation. When cytokines bind to the receptor, JAK is phosphorylated and activated, which subsequently leads to phosphorylation and dimerization of STAT [36, 37]. The activated STAT dimer migrates to the nucleus and binds to specific DNA sites, ultimately causing changes in cell function. STAT1, which is a major transcription factor that is activated by IFN, plays a crucial role in normal immune responses and is critical for M1 macrophage polarization. STAT1 activates the expression of several proinflammatory genes. It has been reported that suppressing STAT1 facilitates M2 macrophage polarization [38].
Both NF-κB and JAK-STAT are involved in regulating cell behaviors. NF-κB and JAK-STAT signaling pathways can independently cause cytokine storms that regulate immune inflammatory responses, while the secretion of inflammatory factors can in turn initiate each other’s responses. According to previous reports, STAT-NF-κB synergistically shaped the transcriptional response to infection [39]. And the synergistic effects between the NF-κB and STAT1 pathways might be the main pathway of M1 polarization [6]. All these studies verified that there is certain interaction between NF-κB and JAK-STAT pathways. Our RNA-seq and Western blot results indicated that the inflammatory process was suppressed via the NF-κB and JAK-STAT signaling pathways in the A20 group. However, this modulatory effect might be achieved through the indirect interactions between NF-κB and JAK-STAT pathways rather than the direct interactions of protein-colocalization.
Aligned nanofibers facilitated wound healing in the skin defects in mice
The dorsal skin defects of mice in the three groups healed over time, and wound healing was significantly promoted in the A20 group. The residual wound area in the A20 group was the smallest on day 14, and the wound trace diagram made the results more intuitive (Fig. 4A). The line chart showed a similar trend, and there was a significant difference between the A20 group and the Con group on day 7 and a significant difference between the A20 group and the other two groups on day 14 (Fig. 4B and C).
Immunofluorescence staining was performed to observe the distribution of M1 and M2 macrophages in skin tissue sections on days 7 and 14. Immunofluorescence images on day 7 showed a large number of CD86-labeled M1 macrophages in all three groups; however, a relatively lower number of M1 macrophages was observed in the A20 group (Fig. 4D). Immunofluorescence staining for iNOS at the two time points also showed similar results (Additional file 1: Fig. S2). CD206-positive cells were significantly increased in the A20 group compared to the other two groups and were mainly concentrated in the sites of the skin defects (Fig. 4E). On day 14, the A20 group still exhibited the fewest CD86+ cells (Fig. 4H), and CD206+ cells were mostly found in the A20 group (Fig. 4I). The statistical analysis of the mean fluorescence intensity was shown in Fig. 4F, G, J and K, and the differences were statistically significant.
Unlike humans, mice develop spontaneous contractures after skin defects [40]. Therefore, 10 mm diameter silicone was sewn onto the backs of the mice to alleviate contracture. Encouragingly, the A20 group showed accelerated healing results from day 7 onward. Hu et al. also reported similar results, and verified that aligned nanofibers could promote active extracellular matrix synthesis [41]. Based on our previous experiments, we hypothesized that A20 promoted the polarization of M2 macrophages in the wound area earliest and improved the anti-inflammatory response. Later, M2 macrophages produced a large number of cytokines to promote tissue regeneration, which could mobilize fibroblast differentiation and eventually promote wound healing. The immunofluorescence staining results also confirmed this hypothesis. Abundant M1 macrophages were observed in all three sections, indicating a progressive inflammation stage in wound sites. The high expression of CD206 in the A20 group suggested that vigorous tissue regeneration was taking place, which was also consistent with the progression of wound healing.
Subsequently, HE and Masson staining was conducted to assess the process of wound healing. The H&E staining results are shown in Fig. 5A. The thickest regenerated granulation tissue and the fewest inflammatory cells, such as macrophages and neutrophils, were observed in the A20 group on day 7. In addition, there were more regenerated vessels in the A20 group than in the other groups. By the 14th day, a more complete epidermal layer was produced in the A20 group than in the other groups. The wound surface was covered with a more complete epidermal structure, more collagen deposition and fewer inflammatory cells were observed than in the other two groups. These results showed that the repair quality was the best in the A20 group.
Collagen deposition is an important indicator of wound healing. After Masson staining, the collagen fibers were stained blue, and their relative intensity indicated the collagen content [42]. On day 7, collagen was fully deposited and densely arranged in the A20 group, and the neoplastic epithelial layer was more visible than in the other groups. In addition, on day 14, collagen deposition was significantly higher in the A20 group than in the other groups, and collagen fibers were intertwined to form a network structure (Fig. 5B).
Furthermore, TGF-β1 and CD31 immunofluorescence staining was performed to investigate tissue regeneration and neovascularization in the skin samples. The immunofluorescence images of TGF-β1 (Fig. 5C) on days 7 and 14 showed that the level of TGF-β1 increased with time, and its expression was higher in the A20 group at both time points. Figure 5D shows the immunofluorescence staining of CD31, and that there was more CD31-labeled neovascularization in the A20 group on days 7 and 14. The statistical analysis of the mean fluorescence intensity of TGF-β1 and CD31 on days 7 and 14 were shown in Fig. 5E, F, G and H, and the differences were statistically significant.
Tissue-resident macrophages may be the earliest responders to traumatic injury. After injury, the cells synthesize adhesion molecules that recruit and direct a variety of cell types. These macrophages are subsequently highly polarized to the M2 phenotype in response to IL-4 and coordinate the wound healing phase [43]. M2 macrophages can express TGF-β1, a multifunctional growth factor that regulates the proliferation, migration and differentiation of functional cells, modulates ECM production, exerts immunomodulatory effects, and ultimately promotes wound healing.
The proliferation stage of wound healing mainly depends on fibroblasts, which are responsible for initiating angiogenesis and synthesizing collagen fibers [44]. We hypothesized that aligned nanofibers polarized macrophages to the M2 phenotype, which contributed to the migration and proliferation of fibroblasts. In addition, TGF-β1 secreted by M2 macrophages promoted not only the proliferation of fibroblasts and epidermal cells but also the synthesis of extracellular matrix, which was closely related to wound healing and affected almost every stage of wound healing [45]. In a model of idiopathic pulmonary fibrosis, the production and activation of TGF-β1 was responsible for the profibrotic effects of macrophages [46]. In addition, a robust and dynamic angiogenic response has been reported to be essential for wound healing, and new capillaries provide nutrients and oxygen for wound healing [47, 48]. Macrophages can mediate angiogenesis in wound healing and secrete regulatory factors to influence neointimal growth [49]. A widely accepted opinion is that the M2 phenotype is closely associated with angiogenic activity through the synthesis of angiogenic growth factors [50, 51].
Macrophage-conditioned medium from the A20 group promoted the biological behaviors of L929 fibroblasts and MAECs
Next, the effect of macrophage conditioned medium on the biological behaviors of L929 and MAEC cells was explored. As shown in Fig. 6A, A20-CM accelerated the migration of L929 fibroblasts compared with that in the Con-CM and R20-CM groups. Immunofluorescence staining showed that the A20-CM group expressed higher levels of fibronectin than the Con-CM and R20-CM groups (Fig. 6B). The CCK-8 assay showed that the OD value in the A20-CM group was significantly higher than that in the other groups on days 4 and 7 (Fig. 6C). Moreover, qPCR was used to measure the expression of collagen formation-related genes, and A20-CM significantly upregulated the expression of fibronectin and COL-III in L929 fibroblasts; COL-I was not significantly different among the three groups (Fig. 6D).
The CCK-8 assay results (Additional file 1: Fig. S3) indicated that all the conditioned medium promoted the proliferation of MAECs, and the OD value in the A20-CM group was significantly higher than that in the other groups on day 7. Additional file 1: Fig. S4 shows that A20-CM facilitated the migration of MAECs. The results of qPCR (Additional file 1: Fig. S5) showed that A20-CM upregulated the expression of angiogenesis related genes.
Fibroblasts play an important role in skin wound healing by promoting angiogenesis and facilitating epithelialization and collagen production. After injury occurs, fibroblasts migrate to the damaged sites and proliferate under the stimulation of cytokines secreted by M2 macrophages, which is the basis for tissue reconstruction. Angiogenesis is also essential for the maintenance of granulation tissue and is associated with the activity of a large number of cytokines (e.g., bFGF and TGF-β). Granulation tissue formation, collagen deposition and angiogenesis occur simultaneously with epithelialization and wound contraction. Subsequently, fibroblasts secrete type III collagen and fibronectin, resulting in mechanically strong tissue. Fibronectin is essential in all three phases of wound healing: inflammation, proliferation, and remodeling [52]. Fibronectin regulates cell adhesion kinetics and subsequently provides the necessary ECM templates for collagen deposition [53]. A20-CM promoted the migration and proliferation of fibroblasts in vitro and upregulated the expression of fibronectin and COL-III. According to our previous experiments, we hypothesize that macrophages cultured on aligned nanofibers synthesized increased levels of regenerative factors, such as TGF-β1, which could result in higher expression of fibronectin and COL-III. Relevant studies also indicated that TGF-β1 could induce cellular expression of fibronectin in skin wounds to promote repair and wound healing [54].