Smart hybrid nanomaterials for chronic infections: microbiome-responsive and sustainable therapeutic platforms

Chronic wounds remain a persistent clinical challenge due to their complex pathology involving prolonged inflammation, microbial biofilms, and impaired tissue regeneration. Emerging research highlights the dynamic role of the human microbiome in modulating immune responses and influencing wound healing outcomes. Disruptions to this microbial balance, termed dysbiosis, not only exacerbate infection but also hinder therapeutic efficacy. Recent advances in smart and sustainable nanotechnology offer promising avenues to address these challenges. By integrating microbiome-sensitive mechanisms with targeted delivery systems, bio-based nanomaterials can overcome multidrug resistance, modulate inflammation, and accelerate healing. This review explores the molecular interplay between chronic infections and host immunity, highlights next-generation nanomaterials for regenerative applications, and proposes a sustainable paradigm that bridges clinical effectiveness with environmental responsibility.