JOURNAL OF MEDICAL & CLINICAL CASE REPORTS

Abstract

Recent developments in nanotechnology have opened new avenues in clinical blood detoxification by overcoming the limitations of traditional methods such as hemodialysis, hemodiafiltration, plasmapheresis, and hemoperfusion. Among these innovations, nanofiber mesh technology stands out for its exceptional surface area, high porosity, and functional versatility, enabling targeted removal of toxins, including protein-bound solutes and uremic toxins, without disrupting essential biomolecules. Electrospun nanofiber meshes, composed of biocompatible polymers and functionalized with materials such as activated carbon, zeolites, and metal-organic frameworks, demonstrate enhanced adsorption efficiency and hemocompatibility. Their ability to integrate selective binding mechanisms, combined with minimal infrastructure requirements, positions them as a promising next-generation solution for extracorporeal blood purification. While most evidence remains preclinical, early in vitro and in vivo models have shown favorable performance in terms of safety, detoxification efficacy, and hemocompatibility. This article highlights the mechanisms, fabrication techniques, clinical potential, and future directions of nanofiber-based blood detox systems, laying a foundation for their translational application in managing critical conditions such as acute poisoning, renal failure, and inflammatory syndromes.

Keywords: Nanofiber Mesh; Blood Detoxification; Electrospinning; Toxin Adsorption.

►Advanced Nanofiber Mesh Technology for Clinical Blood Detoxification: A New Frontier in Translational Nanomedicine

Gnanendra Sai Kumar Nareboina^1*, Poojitha Bandaru¹, Uma Bekkam², Reena Varshitha Saripalli¹, Keerthi Vallapureddy¹, Satya Jagadeesh Botta², Girish Kombathula², Pavan Kumar Pothanapalli²

¹Research Scholar, Department of Pharmacy Practice, GIET School of Pharmacy, Rajahmundry, Andhra Pradesh, 533296, India.

²Research Scholar, Department of Pharmaceutical Sciences, GIET School of Pharmacy, Rajahmundry, Andhra Pradesh, 533296, India.

Introduction

Blood detoxification is a critical clinical intervention aimed at eliminating harmful substances such as toxins, drugs, and metabolic byproducts from the bloodstream, particularly in cases of poisoning, metabolic imbalances, or specific systemic diseases. Traditional methods like hemodialysis, hemodiafiltration, plasmapheresis, and hemoperfusion have long been used in clinical practice to facilitate extracorporeal toxin removal. However, these conventional techniques often present limitations such as incomplete clearance of certain compounds and risks, including coagulation, infection, and biocompatibility issues [1]. Recent advances in surface engineering and nanotechnology, particularly nanofiber mesh materials that offer promising alternatives to these limitations. Owing to their high surface area, structural tunability, and selective binding capabilities, nanofiber meshes can be engineered to remove a wide spectrum of toxins more effectively and safely. Unlike traditional filters, they provide enhanced interaction with target molecules and may significantly improve therapeutic outcomes. The development and clinical translation of nanofiber mesh technology could revolutionize detoxification protocols, offering novel solutions for acute and chronic conditions requiring blood purification [2].

Conventional Clinical Blood Detoxification Methods

Conventional blood purification methods remain the clinical standard for managing various toxic and metabolic conditions. These techniques rely on physical principles such as diffusion, convection, and adsorption etc to remove toxins from blood, and are widely used despite their limitations. The following subsections provide a concise overview of key conventional methods, including their procedural flow and inherent drawbacks.

Hemodialysis (HD)

Hemodialysis is one of the oldest and most proven ways of blood purification, which is regularly applied for the treatment of patients with kidney disease. This is done by pumping the patient’s blood through a machine that separates out poisons and extra water. The patient under dialysis has body fluids as electrolytes, water, and other smaller molecules, such as urea and creatinine, removed through the use of a semi-permeable membrane in the dialysis machine. Although very effective with small-molecule toxins or other small molecular weight substances, it is not very effective with large toxins that are protein-bound. The mechanism of solute removal via diffusion across membranes is shown in Fig. 1 [3].

Fig. 1. Hemodialysis process flow showing solute diffusion across a semi-permeable membrane.

Limitations

• The large biomolecules, such as proteins and lipids, can’t be effectively removed.
• This may cause hypotension, nausea, blood clot formation, and muscle cramps during the process.
• This requires frequent sessions at least three times per week [4,12].

Hemodiafiltration (HDF)

An example of the other blood purification process is Hemodiafiltration, which is a technique for filtering blood that is frequently applied in critical care practice and essential for patients with AKI (Acute Kidney Injury). In this method, a membrane separates blood and the filtrate is replaced by a sterile solution. Hemodiafiltration has been preferred over hemodialysis because it can filter out larger molecular-sized substances. Nevertheless, it has some shortcomings in properly addressing some toxins with a great potential for fast interaction. Combined convective and diffusive toxin clearance in hemodiafiltration is outlined in Fig. 2 [5].

Fig. 2. Hemodiafiltration flowchart illustrating combined convective and diffusive toxin removal.

Limitations

• Patients may develop allergic reactions, or anaphylaxis, to the replacement fluids used during the process.
• Risk of hypocalcaemia as a result of practices that involve the use of anticoagulant drugs.
• Effective only for single sessions or follow-up appointments for different complaints; could take a longer time and prove expensive for patients with chronic diseases.
• Can result in infection of the catheter site, particularly when the catheter is used for a very long period [11,12].

Challenges and Solutions in Clinical Detoxification

Hemodialysis, hemodiafiltration, plasmapheresis, and hemoperfusion are well-established techniques for removing toxins from the bloodstream. However, each of these conventional approaches presents specific limitations that reduce their overall effectiveness. For instance, hemodialysis struggles to eliminate protein-bound toxins and relies entirely on dialysis solutions for toxin removal. In contrast, hemodiafiltration shows limited capacity in clearing large molecular toxins and typically requires high-pressure systems, which can induce fluctuations in blood pressure [11-13].

Plasmapheresis often necessitates plasma replacement to prevent nutritional loss, making the procedure complex and costly. Moreover, hemoperfusion can trigger inflammation or blood cell damage due to non-biocompatible adsorbents and indiscriminately removes both harmful and beneficial molecules [14,15]. In response to these limitations, nanofiber mesh-based detoxification offers a promising alternative. This technology selectively removes protein-bound toxins without the need for dialysis solutions, thus addressing key shortcomings of hemodialysis. It is capable of eliminating both small and large toxins efficiently, without depending on high-pressure systems, thereby reducing the risk of blood pressure instability common in hemodiafiltration.

Unlike plasmapheresis, nanofiber meshes do not require plasma separation or replacement, simplifying the detoxification process and minimizing associated costs. Additionally, they are engineered with biocompatible materials, which help to prevent blood cell damage and inflammatory responses seen in hemoperfusion. Their selective adsorption capability allows for the removal of only harmful substances while preserving beneficial biomolecules, presenting a safer and more targeted approach to clinical blood detoxification. The challenges of conventional clinical detoxification methods and potential solutions with nanofiber mesh technology were shown in Fig. 5 [16-19].

Advanced Nanofiber Mesh Technology: A Novel Approach

The use of nanofiber mesh in the medical field represents a significant innovation, particularly in blood purification applications. This technology involves the fabrication of ultrafine fibers typically measuring at least one nanometer in diameter using electrospinning techniques that enable precise control over fiber diameter and distribution. Owing to their unique structure, nanofiber meshes offer a high surface area to volume ratio, making them highly effective in filtering undesirable substances (toxins, drugs and metabolic waste products) from the blood stream. This capability positions nanofiber meshes as a promising enhancement to conventional blood detoxification methods like hemodialysis, hemodiafiltration, plasmapheresis, and hemoperfusion [20,21].

One of the most notable features of nanofiber meshes is their adaptability. They can be functionalized to selectively bind specific toxins, thereby improving their detoxification efficiency beyond that of standard filtration approaches. Moreover, their high porosity promotes smooth blood flow, reducing the risk of clotting and infection often associated with traditional methods. Nanofiber materials are also largely biocompatible, minimizing the likelihood of immune responses or adverse foreign body reactions. Overall, nanofiber mesh technology holds the potential to revolutionize clinical blood detoxification, offering a safer and more efficient alternative to existing practices [22,23].

Composition of Nanofiber Mesh for Clinical Blood Detoxification

Nanofiber meshes for blood detoxification are typically fabricated from biocompatible synthetic polymers, often blended with functional adsorbents or coatings to target toxins.  Common base polymers include poly (ethylene‑co‑vinyl alcohol) (EVOH), polyethersulfone (PES), polyacrylonitrile (PAN), polycaprolactone (PCL), cellulose acetate (CA), regenerated cellulose, and chitosan or other biopolymers [24-26]. These fibers are often electrospun as nonwoven meshes to maximize surface area.  To improve the adsorption of uremic toxins or inflammatory mediators, the nanofibers are frequently combined with inorganic or organic adsorbents. Several nanofiber composites have been engineered to improve toxin removal efficiency. For instance, EVOH-based fibers loaded with activated carbon (AST-120) have been developed to specifically adsorb indoxyl sulfate. Likewise, combining zeolites with EVOH and PES polymers enhances their ability to trap uremic waste. In other studies, PAN fibers coated with metal-organic frameworks like Cu-BTC showed improved urea binding, while functionalized PAN-clay blends were tailored to boost bilirubin clearance by introducing positively charged groups such as lysine. [27,28].

Besides inorganic additives, nanofibers are frequently functionalized chemically or with biological ligands.  For instance, PAN fibers grafted with branched polyethyleneimine or lysine introduce cationic binding sites for bilirubin.  Regenerated cellulose fibers have been surface-modified with affinity dyes (e.g., Cibacron Blue) to selectively bind bilirubin and other proteins.  In advanced designs, multilayer meshes combine different materials: one reported hemodialysis membrane had a dual-layer structure, an inner layer of polydopamine-coated PAN fibers modified with a Cu-BTC MOF, and an outer layer of chitosan/sericin fibers, achieving high urea and creatinine clearance with excellent hemocompatibility.  Natural proteins like albumin may also be immobilized on fiber surfaces (e.g., via covalent linkage) to serve as “bait” for protein-bound toxins (as in a 3D nanofiber sponge, where surface-bound BSA enhanced bilirubin uptake). A variety of mesh formulations and their specific toxin targets are compared in (Table 1) [24-30]. In summary, clinically oriented detox meshes typically use biostable polymers (EVOH, PAN, PES, PCL, cellulose, etc.) combined with nanoporous adsorbents (activated carbon, zeolites, MOFs) or functional coatings (e.g. polydopamine, albumin, ionic polymers) to achieve high toxin capture while maintaining structural integrity. Material composition and structural features of nanofiber meshes are detailed in Fig. 6 [24-30].

In Vitro vs In Vivo

Most evidence so far is from bench tests or small animal studies. In vitro blood loop or plasma perfusion experiments generally show that well-designed nanofiber meshes cause no significant hemolysis or thrombosis. One recent calculation-guided PAN adsorbent study explicitly demonstrated that its blood compatibility is sufficient for safe hemoperfusion. In vivo data are still emerging, but existing reports (e.g. animal models of nanofiber implants) suggest minimal inflammatory reaction and good integration when fibers are properly functionalized [26].

Biofouling from proteins or cells remains a concern; accordingly, nanofibers are often tested for protein adsorption. For example, electrospun meshes with high-density cationic sites showed anti-fouling behavior (low nonspecific protein adhesion). Overall, the trend is that modern nanofiber adsorbents, especially those employing anti-thrombogenic coatings, demonstrate excellent hemocompatibility in vitro. Further preclinical and clinical studies will clarify in vivo performance, but early work indicates these meshes can match or exceed the blood-compatibility of legacy dialysis/adsorbent materials [33].

Engineered Blood Detoxification Mechanisms of Nanofiber Mesh Technology

Recent studies show that electrospun nanofiber meshes can remove blood toxins via multiple mechanisms.  Nanofibers have extremely high surface area and porosity, providing abundant binding sites.  Key detoxification pathways include the following:

Adsorption / Filtration

Toxins physically adsorb onto the fiber surface or get trapped in the porous network. For example, zeolite–polymer composite nanofibers (poly(ethylene-co-vinyl alcohol) matrix with incorporated zeolite) were shown to selectively adsorb small uremic toxins like creatinine. Similarly, activated carbon loaded nanofibers (e.g. EVOH/AST-120 fibers) rapidly adsorb protein-bound uremic solutes (indoxyl sulfate), with diffusion of toxin into the fiber pores being rate-limiting [39-42].

Electrostatic / Chemical Binding

Nanofibers can be functionalized with charged or reactive groups to bind toxins. Studies have demonstrated that combining zeolites with EVOH polymer matrices in nanofiber form enhances the selective capture of small toxins such as creatinine. In a similar approach, nanofibers infused with activated carbon particles have shown rapid binding of protein-associated toxins like indoxyl sulfate, where the movement of toxins into the fiber's porous structure plays a key role in the overall efficiency [26,43].

Affinity / Selective Targeting

Specific ligands can be attached to nanofibers for targeted binding.  A prominent example is polymyxin B immobilized on a nanofiber sponge: this ligand binds bacterial endotoxin (LPS) with very high specificity.  In one report, PMB-functionalized fibers removed ~99.6% of endotoxin from protein-containing solution versus only ~17% by unmodified fibers.  This demonstrates selective toxin capture without excessively depleting serum proteins.  Enzymes or antibodies could be similarly grafted to degrade or target specific uremic toxins [44].

Size Exclusion (Microfiltration)

The fiber mesh can physically filter out cells, bacteria, or large complexes.  With fiber diameters in the nano- to micron-range, nanofibrous mats act as microfiltration membranes.  Although blood filters must preserve cells, nanofibers could remove cellular debris or agglomerates that carry toxins.  In other industries, electrospun membranes have been shown to microfilter bacteria or viruses, suggesting similar potential in blood purification [39,44,45]. In summary, nanofiber detox devices combine high porosity and tunable surface chemistry to adsorb a broad range of toxins.  The fibers’ large specific surface area and functional groups allow efficient capture via physical adsorption, electrostatic attraction, chelation, and ligand affinity. Multiple pathways enabling selective toxin removal by nanofiber meshes are visualized in Fig. 7 [26,39-45].

Operational Workflow of Nanofiber Mesh-Based Blood Detoxification

1. Blood Withdrawal and Arterial Pressure Monitoring

First, blood is removed from the body of the patient, purified, and then returned to the patient by the detoxification process. Blood first goes to the Arterial Pressure Monitor, where it continuously measures blood pressure. It also helps to make sure flow rates are stable and to find abnormalities early.

2. Blood Pumping and Heparin Infusion

Then, the blood flows through the Blood Pump and is then propelled forward in the circuit. Heparin Infusion is administered to prevent clotting during the purification process and to keep the blood in a fluid state. It is important because any coagulation in the circuit would block flow and damage the filtration.

3. Filtration Unit with Nanofiber Mesh

The Filtration Unit is the heart and soul of the real detoxification process. The series of nanofiber mesh layers contained in this unit serves as ultra-fine filters. Blood flows through these meshes, and toxins and impurities are trapped within the nanofibers. The ability to act as an efficient filter is based on the structure of the nanofibers in which molecules are captured via size, charge, or chemical composition, and ensure blood is purified while allowing essential components to pass through [46-48].

4. Air Trap and Air Detection

After passing through the filtration unit, it is opened to the air trap and air detector. This is important to detect and eliminate any blood air bubbles that have entered the blood during filtration. Air embolisms, if not detected, could reach the bloodstream and produce serious complications in the patient. The detector makes absolutely sure that only air-free blood enters the patient.

5. Venous Pressure Monitoring

Detoxified blood then reaches the Venous Pressure Monitor site, where it measures pressure before returning to the patient. The pressure at this stage must be monitored to make sure the blood is returning at a safe and level pace.

6. Automatic Clamp Safety Mechanism

The blood then passes through an Automatic Clamp. The safety feature is continuously monitoring for abnormal readings, such as pressure changes and air. If there's something improper going on, the clamp immediately stops blood flow to the patient. With this automatic shut-off, there is one more safeguard for the patient in the case of any system malfunction [49,50].

7. Restoration of Purified Blood

After all checks are complete, the blood is returned to the patient detoxified of harmful toxins and impurities. This completes the detoxification cycle, keeping the patient's bloodstream clean, minimizing the risk of a toxin-based complication. The clinical flow of blood detoxification using Nanofiber mesh technology is represented in Fig. 8 [46-51].

Electrospinning Fabrication of Nanofiber Mesh for Clinical Detoxification

Electrospinning is a voltage-driven process that relies on electrohydrodynamic instability to fabricate nanofiber meshes and, therefore, is one of the most effective approaches to its production. This makes the technique ideal in clinical detoxification applications because the fibers can be created to be as small as nanometers in diameter or up to micrometers [52]. Compared to other, more complicated methods for creating nanostructures, the process is relatively affordable and can be applied to a wide variety of materials, from polymer solutions to melts. The primary advantage of electrospinning is the possibility to achieve a high degree of uniformity in the fiber diameter, and this is also the main parameter that should be controlled in order to create the nanofiber meshes with the desired functionality for medical applications. The electrospinning process for Nanofiber mesh fabrication is shown in Fig. 9 [53,54]. A standard electrospinning setup consists of three essential components: a power supply, polymer solution, and syringe pump. The syringe pump regulates the amount and rate of polymer solution that is delivered to the sample, and the high-voltage power supply charges the electric field through which the solution is forced through the syringe needle. The electric field acts on the polymer solution to produce thin charged liquid jets that freeze to nano-scale fibers upon contact with a collector. This lays down great accuracy, as well as feasibility for the replication. The electrospinning setup is schematically shown in Fig. 10 [55].

Despite the fact that electrospinning has been widely used than other techniques, which is adopted for the fabrication of nanofiber mesh, whereas the other techniques have been used in clinical detoxification, although to a limited extent. Techniques, including freeze-drying, phase separation, have been employed in the production of nanofiber meshes with distinct properties. Also, other types of electrospinning, like coaxial electrospinning and needle-less electrospinning, have gained interest in the fabrication of different types of fibers. These techniques generally work in synergy with electrospun nanofibers since they resolve the issues that can be faced during the fabrication of the nanofiber meshes for clinical detoxification [56-58].

Nanofiber Innovations in Medical Applications

Zeolite Composite Nanofiber Mesh for Indoxyl Sulfate Adsorption

Sasaki et al. (2021) designed a zeolite composite nanofiber mesh that can adsorb indoxyl sulfate (IS), a toxin that is found to be linked to the development of chronic kidney disease. The study identified eight different types of zeolites and concluded that the zeolite with a pore size of 7 Å, H+ cations, and Si/Al ratio of 240 mol/mol adsorbed the most amount of IS. This optimal zeolite was then incorporated with nanofibers through the technique of electrospinning to form the composite mesh. The mesh also exhibited an IS adsorption capacity of 107 mug/g while zeolite, which was in a powdered form, showed an adsorption capacity of 208 mug/g, but in the mesh form, the same zeolite had an adsorption capacity of 386 mug/g. Further, the composite mesh improved the percentage of viable cells from 86% to 96%, which indicates the utility of the material in wearable blood purification systems [86].

Electrospun Cellulose Nanofiber as Affinity Membrane

Ma Z, Ramakrishna (2008) investigated how affinity filtration could be applied using cellulose nanofiber membranes. Electrospinning process in which a cellulose acetate (CA) solution was transformed to an electret fiber mesh and heat-treated, and the regenerated cellulose (RC) was produced from NaOH. In this work, the RC membrane surface was activated by the introduction of the affinity dye Cibacron Blue F3GA to improve the separation of biomolecules. The CB-functionalized membrane showed binding capacities of 13 for BSA and 4 for bilirubin. It also showed reusability and high filtration efficiency compared to some of the commercially available membranes, making the material suitable for biomolecule separations [87].

Enhanced Hemostatic Efficiency of Sonicated Chitosan Nanofiber Mats

Gu et al. (2013) constructed a chitosan nanofiber mat by using an electrospinning technique for the preparation of an efficient hemostatic material. To counteract water solubility, the best conditions for neutralization employing different kinds of alkalis were identified. To achieve this, the mat underwent ultrasonication that improved the porosity and structures of the mat, thereby raising porosity from 79.9%" to 97.2% and water absorption time from 110s to 9s. Sonicated chitosan mat has significantly higher efficiency on blood coagulation compared with that of Surgicel® and chitosan sponge, with an increase rate of 1.35 folds 3.41-fold, respectively. Moreover, fibroblast proliferation was: 1.4+/−0.2 on the sonicated mat compared to 1.0+/−0.2 on the [non-sonicated] mat, which could be useful in more complex applications of advanced wound healing [88].

Porous Nanofiber membrane for Endotoxin Removal

Wu et al. (2024) fabricated a porous nanofiber/microparticles (PNfMp) membrane based on the renal glomerular structure using an electrospray technique. The process employed a binary solvent of tetrahydrofuran (THF) and methanol to create highly porous structures of Poly(styrene-random-glycidyl methacrylate)(PSGM). It was able to get a very high surface area of about 986.6 m²/g, which was determined using the Brunauer-Emmett-Teller (BET). When the membrane surface was firmly attached to polymyxin B (PMB) on the epoxy groups, the adsorption ability of endotoxin was significantly enhanced to 3.1 EU/mg, while that of the non-porous membrane was 0.7 EU/mg. The authors described the use of this PMB-modified membrane filter for the purification of human plasma and achieved endotoxin reduction of approximately 99.7% at a flow rate of 1 mL/min [89].

Double-layered Nanofiber Filter for Urea & Ammonium Removal

Sasaki et al. (2024) proposed a double-layered nanofiber filter to alleviate the issues of urea and ammonium clearance in WAKs. Urease immobilized poly (ethylene-co-vinyl alcohol) (EVOH)/chitosan nanofiber demonstrated a considerable depollution rate of 690mg/g per hour. On the other hand, the sodium cobalt(II) hexacyanoferrate(II) (NaCoHCF) incorporated EVOH nanofiber has a maximum adsorption of ammonium up to 135.5mg/g. The comparison of the double-layered membrane indicated a good rate of urea breakdown, and ammonium decrease by 90% after cycling constantly. This is a great leap in the advancement of WAKs for usage in managing chronic kidney diseases [90].

Advanced Nanofiber Meshes for Improved Pelvic Organ Prolapse Treatment

Mukherjee et al. (2020) used endometrial mesenchymal stem/stromal cells (eMSCs) and bioengineered electrospun poly L-lactic acid-co-poly ε-caprolactone nanofibrous meshes (P nanomesh) for pelvic organ prolapse (POP) treatment. In one mouse model, increased integration with tissue, diminished acute inflammation, and increased score across 35 genes related TO ECM, angiogenesis, and immunomodulation were found with the bioengineered meshes in comparison with standard P nanomesh. This innovation serves to overcome some of the challenges posed by the traditional type of POP treatments [91].

Nanofiber-Enabled Blood Vessel Specification for Bone Repair

Zhai et al. (2021) studied the spatiotemporal characteristics of blood vessels in bone tissue regeneration with the help of nanofiber mesh constructs. Using the various imaging techniques, they characterized arterial-like (CD31+EMCN-) and venous-like (CD31+EMCN+) vessels, which displayed higher oxygen levels and flow rates in arterial-like vessels. It was also evidenced that donor osteoblast clusters are located around the newly established venous-like vessels, which interconnect with arterial-like vessels. This work also showed the difference in the distribution of vessel type in the regions with healing and non-healing defects, highlighting the importance of nanofiber-improved vascularization in the bone tissue regeneration [92].

Nanofiber Scaffolds for Acute Liver Failure Treatment

Liu et al. (2024) studied the application of nanofiber scaffolds in LTE as a possible substitute for transplantation for ALF, which has a more than 40% mortality rate. These scaffolds resemble the structure of the ground substance that forms the basis of an ECM and encourages the growth of cells and the healing of tissues. The review focuses on recent developments in fabricating scaffolds, the application of scaffolds in controlling liver cell functions, and the challenge of linking seeding cells together with growth factors. It also describes the present issues and the future direction with regard to the perspective scaffold design for the treatment of ALF [93].

EGCG-Loaded PLGA Nanofiber Membranes for Adhesion Prevention

Shin et al. (2014) fabricated biodegradable nanofiber membranes composed of PLGA containing EGCG for the prevention of postsurgical adhesions. The membranes, which had fibers with an average diameter of 300-500 nm, demonstrated a controlled release of EGCG over 28 days due to diffusion and the degradation of PLGA. EGCG improved the antioxidant characteristics and biocompatibility of membranes, reducing the formation of HO and increasing the clotting time. The in vivo studies employing the rat models showed that the EGCG-enriched PLGA membranes effectively mitigated the formation of tissue adhesions, as indicated in comparable outcomes with the commercial antiadhesion barrier products. These results point to the possibility of using PLGA nanofibers incorporating EGCG in surgical applications as an effective modality in enhancing the healing rate and preventing the formation of adhesions [94].

Nanofiber-Based Endothelialization for Blood-Compatible Interfaces

Weidenbacher et al. (2019) designed a nanofiber-based interface for endothelialization on elastic silicone material used in ventricular assist devices (VADs). They developed an elastic polyurethane and poly (vinylidene fluoride-co-hexafluoropropylene) membrane that is embedded in silicone that minimizes deformation and increases antithrombotic characteristics. For example, to create an environment in a pulsatile flow bioreactor that mimics the conditions of in vivo conditions, this material was characterized in maintaining stable endothelial cell formation. This approach holds promise for the development of blood-compatible materials for the next-generation VADs [95].

Future Directions

The discussion would be incomplete without emphasizing the adaptable nature of nanofiber mesh technology. This also includes new materials like nanoparticles, biomolecules, or responsive polymers for better designing of these meshes to selectively bind a broad range of toxins, such as heavy metals, synthetic drugs, and metabolic by-products [96]. Further investigations into optimizing pore size and surface area for increasing binding efficiency for various toxins could guarantee faster and more selective detoxification procedures. These advances can very much expand the therapeutic horizon for nanofiber meshes in clinical practice [97-99].
Developing the Nanofiber meshes to meet the requirements of patient specificity must be focused along with the adaptability of meshes in different fields of study. These would include designing meshes based on individual patient profiles, taking into account the type of toxins, nature of the body, and treatment durations. Also, the practices using 3D printing or computational modeling would obtain this capability. These would be complemented by the inclusion of antimicrobial agents into the mesh to avoid secondary infections during detoxification, and those are often concerning in critically ill or immunocompromised patients. Together, these would guarantee advances in positioning nanofiber meshes as integral elements within precision medicine [100,101]. There are other exciting avenues to explore around synergistic opportunities from nanofiber mesh technology and real-time monitoring systems. Embedding such sensors within the mesh effectively allows for continuous tracking of the toxin levels throughout the detoxification process and points out such essential data to the clinicians. This would certainly bring up the adaptability of the detoxification protocol in various therapeutic studies, resulting in some positive outcomes. The additional developments toward reusable or self-cleaning nanofiber meshes should address cost evaluation and increase the opportunities for widespread clinical use of nanofiber mesh technology. These forward-looking strategies articulate with significant goal for enhancing the efficacy, safety, and sustainable detoxification therapies [102,103].

Conclusion

The transition from conventional blood detoxification techniques to nanofiber mesh-based systems reflects a significant leap in therapeutic innovation. Nanofiber meshes demonstrate a combination of structural precision, customizable surface chemistry, and excellent biocompatibility, making them well-suited for clinical applications. Their selective adsorption mechanisms allow for efficient removal of toxins—including protein-bound and hydrophobic compounds—while minimizing harm to essential blood components. Furthermore, advancements in fabrication processes such as electrospinning have enabled scalable production of functional meshes with high reproducibility. Compared to traditional modalities, nanofiber systems offer the potential for portable, cost-effective, and patient-friendly solutions. However, despite encouraging laboratory results, large-scale clinical trials and long-term safety evaluations remain essential before these technologies can be adopted into routine medical practice. With continued interdisciplinary research, nanofiber mesh technology may redefine standards in blood purification, offering improved patient outcomes and reducing the burden on critical care systems.

Ethical Statement

This article is a narrative review that does not involve any new studies with human participants or animals performed by any of the authors. Therefore, ethical approval was not required for this work.

Consent to Participate

This article is based solely on previously published literature. No human participants were involved, and no personal data were collected. Therefore, informed consent to participate is not applicable.

Funding

This review article did not receive any funding from an institution or organization.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

CRediT authorship contribution statement

Gnanendra Sai Kumar Nareboina: Conceptualization, Data curation, Methodology, Resources, Writing – original draft, Writing – review & editing, Visualization, Supervison.

Poojitha Bandaru: Resources, Data curation, Investigation, Visualization, Writing – original draft.

Uma Bekkam: Resources, Investigation, Formal Analysis, Writing – original draft.

Reena Varshitha Saripalli: Formal Analysis, Software, Visualization.

Keerthi Vallapureddy: Resources, Visualization, Data curation.

Satya Jagadeesh Botta: Investigation, Validation, Software.

Girish Kombathula: Validation, Formal Analysis, Investigation.

Pavan Kumar Pothanapalli: Formal Analysis, Investigation, Validation.

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