The multifunctional glycosaminoglycan: mechanistic insights into chondroitin sulfate driven tissue repair

Abstract

Abstract Chondroitin sulfate is increasingly recognized as a multifunctional bioactive molecule with therapeutic relevance rather than a passive structural component of the extracellular matrix. At the molecular level, it regulates varied biological processes such as growth factor signaling, inflammatory cascades, angiogenic response, and extracellular matrix remodeling. Through these interconnected functions, CS plays a pivotal role in orchestrating the sequential phases of wound healing. In recent years, the focus has shifted from understanding its endogenous regulatory roles to exploiting its therapeutic potential. The use of CS in biomaterial scaffolds, topical treatments, and sophisticated drug delivery systems has been highly promising in terms of augmenting tissue regeneration and overall improving wound repair outcomes. This review synthesizes emerging insights into the molecular mechanisms of CS and elucidates how these translate into clinical and biomedical applications for wound management. By bridging fundamental biology with translational approaches, CS emerges as a top contender for next-generation regenerative therapy development. GRAPHICAL ABSTRACTDiagram illustrating chondroitin sulfate, highlighting sources, biological functions, applications, and fabrication into biomaterials.The diagram centers on "Chondroitin Sulfate" surrounded by four quadrants: "Sources & Extraction" with shark cartilage, a plant analogue, and extraction techniques; "Biological Functions" showing fibroblast remodeling, ECM stabilization, and immunomodulation; "Applications" depicting wound healing, angiogenesis, and re-epithelialization with related visuals; and "Fabrication into Biomaterials" featuring aerogel, nanofibrous scaffold, and hydrogel patch. The layout emphasizes the connections between sources, functions, and applications of chondroitin sulfate.