Wound healing emerges from a tightly orchestrated bioelectric landscape shaped by ion gradients, membrane potentials, and redox dynamics physical cues that direct cell migration, immune activation, and epithelial organization long before biochemical gradients take form. Recent advances reveal that electrical signals constitute a master regulatory layer: Transient receptor potential (TRP)-channel mediated ion flux governs early wound polarity; endogenous transepithelial potential collapse triggers rapid electric fields that guide keratinocyte and fibroblast migration; and connexin-dependent gap-junction coupling coordinates tissue-level responses across multicellular sheets. Electroceutical strategies exploit these principles by recalibrating electrical and electrochemical environments rather than targeting single molecules. This shift enables simultaneous modulation of ion-channel gating, cytoskeletal dynamics, growth-factor signaling, and immunometabolic programs reshaping whole-tissue behavior in ways unattainable with classical pharmacology. Key breakthroughs demonstrate that controlled electrical stimulation can reprogram human macrophages toward reparative phenotypes, enhance keratinocyte electrotaxis even under diabetic conditions, accelerate fibroblast-driven matrix assembly, and amplify endothelial angiogenic responses. Microbial communities respond in the opposite direction. Biofilms, long considered antibiotic-impervious, depend on exquisitely tuned membrane potential, proton motive force, and redox stratification for cohesion and persistence. Low-intensity electrical cues disrupt this energetics, collapsing efflux pump function, silencing quorum systems, loosening EPS architecture, and destabilizing metabolic heterogeneity effects impossible to escape through single gene mutation. Overall, these discoveries frame electroceuticals as system-level disruptors of microbial order and restorers of host coordination. With the emergence of AI-enabled, closed-loop bioelectronic dressings capable of sensing and responding to wound physiology in real time, electricity is poised to become a foundational operating principle for next-generation regenerative and anti-infective therapy.
Bhasme et al. (Fri,) studied this question.