A Better Disinfectant for Low-Resourced Hospitals? A Multi-Period Cluster Randomised Trial Comparing Hypochlorous Acid with Sodium Hypochlorite in Nigerian Hospitals: The EWASH Trial

Environmental hygiene in hospitals is a major challenge worldwide. Low-resourced hospitals in African countries continue to rely on sodium hypochlorite (NaOCl) as major disinfectant. However, NaOCl has several limitations such as the need for daily dilution, irritation, and corrosion. Hypochlorous acid (HOCl) is an innovative surface disinfectant produced by saline electrolysis with a much higher safety profile. We assessed non-inferiority of HOCl against standard NaOCl for surface disinfection in two hospitals in Abuja, Nigeria using a double-blind multi-period randomised cross-over study. Microbiological cleanliness [Aerobic Colony Counts (ACC)] was measured using dipslides. We aggregated data at the cluster-period level and fitted a linear regression. Microbiological cleanliness was high for both disinfectant (84.8% HOCl; 87.3% NaOCl). No evidence of a significant difference between the two products was found (RD = 2%, 90%CI: -5.1%-+0.4%; p-value = 0.163). We cannot rule out the possibility of HOCl being inferior by up to 5.1 percentage points and hence we did not strictly meet the non-inferiority margin we set ourselves. However, even a maximum difference of 5.1% in favour of sodium hypochlorite would not suggest there is a clinically relevant difference between the two products. We demonstrated that HOCl and NaOCl have a similar efficacy in achieving microbiological cleanliness, with HOCl acting at a lower concentration. With a better safety profile, and potential applicability across many healthcare uses, HOCl provides an attractive and potentially cost-efficient alternative to sodium hypochlorite in low resource settings.

Application of Sulfinate Agent in Conjunction with HOCl Smear-Layer Deproteinization Improves Dentin Bonding Durability of One-step Self-etch Adhesives

PURPOSE

To evaluate the effect of a sulfinate agent on the bonding durability of one-step self-etch adhesives (1-SEAs) to smear-layer-covered dentin deproteinized with hypochlorous acid (HOCl).

MATERIALS AND METHODS

Human coronal dentin disks with a standardized smear layer were deproteinized with 100 ppm HOCl solution for 0 s (control), 15 s or 30 s. After rinsing with water for 30 s and air drying, half of the specimens were treated with a sulfinate agent (Scotchbond Universal Dual Cure Activator; SDA) prior to the application of a 1-SEA (Bond Force II [Tokuyama Dental] or Clearfil Universal Bond Quick [Kuraray Noritake]). Microtensile bond strength (µTBS) was measured after 24 h or 10,000 thermal cycles (TC). The data were analyzed by three-way ANOVA with Tukey's post-hoc tests and t-tests at the 0.05 significance level.

RESULTS

The 24-h µTBS of both adhesives increased statistically significantly with the HOCl pretreatment for 15 s or 30 s (p < 0.05), but it was not statistically significantly affected by the application of SDA (p > 0.05). However, after TC, the groups treated with the combination of HOCl and SDA maintained their µTBS (p > 0.05), as opposed to untreated dentin and dentin treated with either HOCl or SDA, whose µTBS decreased significantly (p < 0.05).

CONCLUSION

The application of the sulfinate agent did not statistically significantly affect the immediate bond strength of 1-SEAs, and it could not prevent a significant decrease in the bond strength to untreated dentin after thermocycling. However, the sulfinate agent significantly improved the bonding durability of 1-SEAs to HOCl smear-layer deproteinized dentin.

Dual-Ratiometric Fluorescent Probe for H2O2 and HClO in Living Cells and Zebrafish and Application in Alcoholic Liver Injury Monitoring

Reactive oxygen species (ROS) are an important component for maintaining normal physiological activities in organisms, and abnormal changes in their level are often accompanied by many diseases. As the two most representative components of ROS, HClO and H₂O₂ play vital roles in many physiological and pathological processes and are interdependent and mutually transformable. Although there is a lot of work that has specifically detected HClO or H₂O₂, there are few reports on the simultaneous differential detection of HClO and H₂O₂. Here, we report a ratio-based fluorescent probe capable of simultaneously distinguishing HClO and H₂O₂ based on making the best use of the untapped potential of coumarin derivatives. This probe was triumphantly put into use in the discriminative identification of HClO and H₂O₂ in aqueous media with high sensitivity and selectivity, and the probe was appropriate in a wide pH range. Furthermore, the imaging experiment for HClO and H₂O₂ in cells and zebrafish was eventually proven to be feasible. Importantly, this probe was qualified for monitoring the variation of HClO and H₂O₂ levels in organisms with alcoholic liver injury.

Acute inhalation toxicity of aerosolized electrochemically generated solution of sodium hypochlorite

OBJECTIVE

The objective was to determine the inhalation toxicity of the electrochemically generated sodium hypochlorite solution after its single administration to laboratory animals in the form of a highly dispersed aerosol.

MATERIALS AND METHODS

The study has been conducted according to the OECD Test Guideline №403 'Acute Inhalation Toxicity.' Laboratory animals were exposed to inhalation of an aerosol containing 1.7 ± 0.13 mg/m³ of active chlorine. The hematological and biochemical parameters of the blood of experimental animals have been determined, as well as specific parameters: the activity of cathepsins B and L, catalase, and α1-antitrypsin. Histological study of the lungs of animals has been carried out.

RESULTS

During inhalation and 14 days after it, no death of the animals was observed; the behavior, appearance, and weight gain did not differ from the control group. There were no significant deviations in hematological parameters, except the decrease in the level of platelets. The biochemical study showed slight changes in the activity of alkaline phosphatase and aspartate aminotransferase on the 1st day after inhalation; these parameters returned to normal within 14 days of observation. Specific biochemical parameters did not show the development of oxidative stress. No specific histological pathologies of lung tissue have been found.

CONCLUSIONS

Thus, the studied electrochemically generated sodium hypochlorite solution under single inhalation exposure in aerosol form practically does not cause a toxic effect. The data obtained allow classifying such solution to the 4th (or even 5th - after additional studies) class of toxicity in accordance with Globally Harmonized System of Classification and Labeling of Chemicals.

Visualizing hypochlorous acid production by human neutrophils with fluorescent graphene quantum dots

In living organisms, redox reactions play a crucial role in the progression of disorders accompanied by the overproduction of reactive oxygen and reactive chlorine species, such as hydrogen peroxide and hypochlorous acid, respectively. We demonstrate that green fluorescence graphene quantum dots (GQDs) can be employed for revealing the presence of the hypochlorous acid in aqueous solutions and cellular systems. Hypochlorous acid modifies the oxygen-containing groups of the GQD, predominantly opens epoxide ring C-O-C, forms excessive C=O bonds and damages the carbonic core of GQDs. These changes, which depend on the concentration of the hypochlorous acid and exposure time, manifest themselves in the absorbance and fluorescence spectra of the GQD, and in the fluorescence lifetime. We also show that the GQD fluorescence is not affected by hydrogen peroxide. This finding makes GQDs a promising sensing agent for selective detecting reactive chlorine species produced by neutrophils. Neutrophils actively accumulate GQDs allowing to visualize cells and to examine the redox processes via GQDs fluorescence. At high concentrations GQDs induce neutrophil activation and myeloperoxidase release, leading to the disruption of GQD structure by the produced hypochlorous acid. This makes the GQDs a biodegradable material suitable for various biomedical applications.

Heme Peroxidases at Unperturbed and Inflamed Mucous Surfaces

In our organism, mucous surfaces are important boundaries against the environmental milieu with defined fluxes of metabolites through these surfaces and specific rules for defense reactions. Major mucous surfaces are formed by epithelia of the respiratory system and the digestive tract. The heme peroxidases lactoperoxidase (LPO), myeloperoxidase (MPO), and eosinophil peroxidase (EPO) contribute to immune protection at epithelial surfaces and in secretions. Whereas LPO is secreted from epithelial cells and maintains microbes in surface linings on low level, MPO and EPO are released from recruited neutrophils and eosinophils, respectively, at inflamed mucous surfaces. Activated heme peroxidases are able to oxidize (pseudo)halides to hypohalous acids and hypothiocyanite. These products are involved in the defense against pathogens, but can also contribute to cell and tissue damage under pathological conditions. This review highlights the beneficial and harmful functions of LPO, MPO, and EPO at unperturbed and inflamed mucous surfaces. Among the disorders, special attention is directed to cystic fibrosis and allergic reactions.

De Novo Design of a Robust Fluorescent Probe for Basal HClO Imaging in a Mouse Parkinson's Disease Model

Elevated HClO gets involved in the pathogenesis of Parkinson's disease (PD). Herein, a novel fluorescent probe NUU-1 was designed and synthesized. Distinct from the general strategies, NUU-1 features two distinct HClO reactive sites, a HClO-specific reaction site and a HClO-nonspecific reactive site, which in turn endows NUU-1 with the "0 + 1 > 1" amplification effect, that thus dramatically promotes the selectivity. NUU-1 displayed a fast response rate (within 15 s), remarkable fluorescence enhancement (about 538-fold), and excellent sensitivity (LOD = 25.8 nM) in response to HClO while the remaining fluorescence silence toward other common ROS (H₂O₂, ^•OH, ONOO^-, O₂^•-, and ¹O₂) even at high concentrations (up to 0.5 mM). NUU-1 allows for the imaging of both exogenous and endogenous HClO in living dopaminergic cells (SH-SY5Y). Moreover, by employing NUU-1 as the probe, the image of HClO in C. elegans and zebrafish was successfully achieved. Significantly, in the first trial, NUU-1 was successfully utilized for the brain basal HClO imaging in PD mice models and distinguished PD brain tissues from normal control, thereby holding great potential for in-depth biological applications.

Hypochlorous Acid-Generating Electrochemical Catheter Prototype for Prevention of Intraluminal Infection

Central line-associated bloodstream infection (CLABSI) contributes to mortality and cost. While aseptic dressings and antibiotic-impregnated catheters prevent some extraluminal infections, intraluminal infections remain a source of CLABSIs. In this proof-of-concept study, an electrochemical intravascular catheter (e-catheter) prototype capable of electrochemically generating hypochlorous acid intraluminally using platinum electrodes polarized at a constant potential of 1.5 electrode potential relative to saturated silver/silver chloride reference electrode measured in volts (V_Ag/AgCl) was developed. After 24 h of prepolarization at 1.5 V_Ag/AgCl, their activity was tested against clinical isolates of Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, and Escherichia coli derived from catheter-related infections. e-catheters generated a mean HOCl concentration of 15.86 ± 4.03 μM and had a mean pH of 6.14 ± 0.79. E-catheters prevented infections of all four species, with an average reduction of 8.41 ± 0.61 log₁₀ CFU/ml at 48 h compared to controls. Polarized e-catheters which generate low amounts of HOCl continuously should be further developed to prevent intraluminal infection. IMPORTANCE Catheter-related infections constitute an economic and mortality burden in health care. Several options are available to reduce the risk of infection, but only a few focus on preventing intraluminal infection, which occurs in long-term catheters, most often used for dialysis, prolonged treatment, or chemotherapy. A prototype of a catheter called an "e-catheter" composed of three electrodes, capable of producing hypochlorous acid (HOCl) electrochemically in its lumen, was developed. When polarized at 1.5 V, chloride ions in the solution are oxidized to continuously produce low amounts of HOCl, which exhibits antibacterial activity in the lumen of the catheter. Here, this prototype was shown to be able to generate HOCl as well as prevent infection in a preliminary in vitro catheter model. This approach is a potential strategy for catheter infection prevention.

The cytotoxic effects of various endodontic irrigants on the viability of dental mesenchymal stem cells

This study aimed to evaluate cytotoxic effects of various irrigation solutions used in regenerative endodontic treatments (RETs) on mesenchymal stem cells, and further examine the long-term effect of hypochlorous acid (HOCl) on the cell viability and alkaline phosphatase (ALP) activity. Stem cells were exposed to various concentrations of NaOCl, EDTA, chlorhexidine (CHX), etidronic acid (HEDP)/NaOCl combination and HOCl. HOCl was tested for its effects on ALP activity up to 21 days. Additionally, cell viability was measured fluorescently using calcein AM. The most cytotoxic irrigant was CHX even with the lowest concentration. NaOCl and HEDP/NaOCl with 1:100 dilution decreased viability to around 40%. HOCl showed the lowest cytotoxicity among all tested irrigants. HOCl also showed no significant reduction in ALP activity compared with the controls. The cytotoxicity of endodontic irrigants was time and concentration dependent. HOCl demonstrated promising results regarding viability and ALP activity, since RETs require host stem cell survival.

Ratiometric Detection of Hypochlorous Acid in Brain Tissues of Neuroinflammation and Maternal Immune Activation Models with a Deep-Red/Near-Infrared Emitting Probe

Reactive oxygen species (ROS) produced by an inflammatory response in the brain are associated with various neurological disorders. To investigate ROS-associated neuroinflammatory diseases, fluorescent probes with practicality are in demand. We have investigated hypochlorous acid, an important ROS, in the brain tissues of neuroinflammation and maternal immune activation (MIA) model mice, using a new fluorescent probe. The probe has outstanding features over many known probes, such as providing two bright ratio signals in cells and tissues in deep-red/near-infrared wavelength regions with a large spectral separation, in addition to being strongly fluorescent, photo- and chemo-stable, highly selective and sensitive, fast responding, and biocompatible. We have found that the level of hypochlorous acid in the brain tissue of a neuroinflammatory mouse model was higher (2.7-4.0-fold) compared with that in normal brain tissue. Furthermore, the level of hypochlorous acid in the brain tissue of a MIA mouse model was higher (1.2-1.3-fold) compared with that in the normal brain tissue. The "robust" probe provides a practical tool for studying ROS-associated neurological disorders.

Unintended Consequences of Air Cleaning Chemistry

Amplified interest in maintaining clean indoor air associated with the airborne transmission risks of SARS-CoV-2 have led to an expansion in the market for commercially available air cleaning systems. While the optimal way to mitigate indoor air pollutants or contaminants is to control (remove) the source, air cleaners are a tool for use when absolute source control is not possible. Interventions for indoor air quality management include physical removal of pollutants through ventilation or collection on filters and sorbent materials, along with chemically reactive processes that transform pollutants or seek to deactivate biological entities. This perspective intends to highlight the perhaps unintended consequences of various air cleaning approaches via indoor air chemistry. Introduction of new chemical agents or reactive processes can initiate complex chemistry that results in the release of reactive intermediates and/or byproducts into the indoor environment. Since air cleaning systems are often continuously running to maximize their effectiveness and most people spend a vast majority of their time indoors, human exposure to both primary and secondary products from air cleaners may represent significant exposure risk. This Perspective highlights the need for further study of chemically reactive air cleaning and disinfection methods before broader adoption.

The Antibacterial Comparison of 5% and 2.5% Povidone Iodine to 0.01% Hypochlorous Acid Using Corneoscleral Tissue as a Solid-Phase Medium

Purpose

Prophylactic topical antiseptics used to eliminate bacteria on the ocular surface prior to ocular surgery should be both effective and non-irritating. Five percent povidone iodine (PI) is an accepted antiseptic used for prophylaxis. Dilute 2.5% PI and 0.01% hypochlorous acid (HOCl) may be more patient comfortable and equally effective. PI at 5% and 2.5% were compared to HOCl against a battery of bacterial endophthalmitis isolates using corneoscleral tissue as a solid-phase medium to determine antiseptic efficacy.

Methods

Bacteria from 20 cases of endophthalmitis were tested for the elimination of growth against topical 5% PI, 2.5% PI, HOCl, and no antiseptic using donor corneoscleral tissue. The tissue was inoculated with 10³ colony forming units of bacteria prior to a 3-minute contact time with the antiseptics, placed in liquid growth medium, and monitored for growth at three days. No growth indicated antiseptic treatment success. Differences were analyzed using Chi square (χ2).

Results

For 20 isolates, 5% PI was comparable to 2.5% PI for preventing bacteria growth (p=0.71), and both were more effective than HOCl (p=0.004). Estimated weighted comparison over a 27-year period indicated that for all bacterial groups, except Streptococcus viridans, 5% PI was equally effective to 2.5% PI for preventing bacterial growth (p=1.0). For Streptococcus viridans, 5% PI was more effective than 2.5% PI (p=0.0001). Both concentrations of PI were more effective than HOCl (p=0.00001).

Conclusion

Five percent PI appears to be optimal as a prophylaxis prior to ocular surgery.

Hypochlorous acid solution is a potent antiviral agent against SARS-CoV-2

Aim

A novel coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) suddenly appeared in Wuhan, China, and has caused pandemic. In this study, we evaluated antiviral activity of purified hypochlorous acid (HClO) against coronaviruses such as SARS‐CoV‐2 and transmissible gastroenteritis virus (TGEV) responsible for pig diseases.

Materials and Results

In a suspension test, 28.1 ppm HClO solution inactivated SARS‐CoV‐2 in phosphate‐buffered saline with the reduction of 10⁴ of 50% tissue culture infectious dose per ml (TCID₅₀ per ml) within 10 s. When its concentration increased to 59.4 ppm, the virus titre decreased to below the detection limit (reduction of 5 logs TCID₅₀) within 10 s even in the presence of 0.1% foetal bovine serum. In a carrier test, incubation with 125 ppm HClO solution for 10 min or 250 ppm for 5 min inactivated SARS‐CoV‐2 by more than 4 logs TCID₅₀ per ml or below the detection limit. Because the titre of TGEV was 10‐fold higher, TGEV was used for SARS‐CoV‐2 in a suspension test. As expected, 56.3 ppm HClO solution inactivated TGEV by 6 logs TCID₅₀ within 30 s.

Conclusions

In a carrier test, 125 ppm HClO solution for 10 min incubation is adequate to inactivate 4 logs TCID₅₀ per ml of SARS‐CoV‐2 or more while in a suspension test 56.3 ppm HClO is adequate to inactivate 5 logs TCID₅₀ per ml of SARS‐CoV‐2 when incubated for only 10 s regardless of presence or absence of organic matter.

Significance and Impact of the Study

Effectiveness of HClO solution against SARS‐CoV‐2 was demonstrated by both suspension and carrier tests. HClO solution inactivated SARS‐CoV‐2 by 5 logs TCID₅₀ within 10 s. HClO solution has several advantages such as none toxicity, none irritation to skin and none flammable. Thus, HClO solution can be used as a disinfectant for SARS‐CoV‐2.

General Strategy to Achieve Color-Tunable Ratiometric Two-Photon Integrated Single Semiconducting Polymer Dot for Imaging Hypochlorous Acid

It is highly desired and challenging to construct integrated (all-in-one) single semiconducting-polymer-derived dot (Pdot) without any postmodification but with desired performances for bioapplications. In this work, eight hypochlorous acid (HClO)-sensitive integrated polymers and corresponding polymer-derived Pdots are designed through molecular engineering to comparatively study their analytical performances for detecting and imaging HClO. The optimized polymers-derived Pdots are obtained through regulating donor-acceptor structure, the content of HClO-sensitive units, and the position of HClO-sensitive units in the polymer backbone. The designed Pdots display distinguished characteristics including multicolours with blue, yellow, and red three primary fluorescence colors, determination mode from single-channel to dual-channel (ratiometric) quantification, ultrafast response, low detection limit, and high selectivity for ClO^- sensing based on specific oxidation of ClO^--sensitive unit 10-methylphenothiazine (PT) accompanied by altering the intramolecular charge transfer (ICT) and fluorescence resonance energy transfer (FRET) processes in Pdots. The prepared integrated Pdots are also applied for two-photon ClO^- imaging in HeLa cells and one- and two-photon ClO^- imaging produced in acute inflammation in mice with satisfactory results. We believe that the present study not only provides excellent integrated fluorescent nanoprobes for ClO^- monitoring in living systems but also extends a general strategy for designing integrated semiconducting polymers and Pdots with desired performances for biological applications.

Hypochlorous Acid Versus Saline Nasal Irrigation in Allergic Rhinitis: A Multicenter, Randomized, Double-Blind, Placebo-controlled Study

BACKGROUND

Low concentrations of hypochlorous acid (HOCl) have proven antipruritic, anti-inflammatory, and antimicrobial effects without toxicity, although the mechanism has not been fully elucidated.

OBJECTIVE

The aim of this study was to evaluate the effectiveness of HOCl nasal irrigation to reduce allergic rhinitis (AR) symptoms compared with saline nasal irrigation.

METHODS

This was multicenter, randomized, double-blind, placebo-controlled study. Initially, 139 patients with perennial AR were enrolled; however, 25 did not successfully complete the study. Patients were randomly assigned to the nasal irrigation with low-concentration HOCl (n = 55) or normal saline (n = 59) treatment groups for the 4-week study period. Participants completed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at every visit (baseline, Weeks 2 and 4), and Total Nasal Symptom Score (TNSS) was determined before and after nasal irrigation every morning and evening.

RESULTS

We found that RQLQ scores significantly decreased after 4 weeks in the HOCl and placebo groups, but the decrement of the RQLQ score was similar between the 2 groups. Additionally, TNSS improved in both groups between baseline and Week 4, whereas there were no significant differences in the change of TNSS between the 2 groups. The HOCl group did not show any clinical side effects related to nasal irrigation.

CONCLUSION

Allergic symptoms significantly decreased with low-concentration HOCl nasal irrigation, without significant adverse events. However, HOCl showed no additional improvement in symptoms compared with saline nasal irrigation for patients with perennial AR.

A Bacterial Inflammation Sensor Regulates c-di-GMP Signaling, Adhesion, and Biofilm Formation

Bacteria that colonize animals must overcome, or coexist, with the reactive oxygen species products of inflammation, a front-line defense of innate immunity. Among these is the neutrophilic oxidant bleach, hypochlorous acid (HOCl), a potent antimicrobial that plays a primary role in killing bacteria through nonspecific oxidation of proteins, lipids, and DNA. Here, we report that in response to increasing HOCl levels, Escherichia coli regulates biofilm production via activation of the diguanylate cyclase DgcZ. We identify the mechanism of DgcZ sensing of HOCl to be direct oxidation of its regulatory chemoreceptor zinc-binding (CZB) domain. Dissection of CZB signal transduction reveals that oxidation of the conserved zinc-binding cysteine controls CZB Zn²⁺ occupancy, which in turn regulates the catalysis of c-di-GMP by the associated GGDEF domain. We find DgcZ-dependent biofilm formation and HOCl sensing to be regulated in vivo by the conserved zinc-coordinating cysteine. Additionally, point mutants that mimic oxidized CZB states increase total biofilm. A survey of bacterial genomes reveals that many pathogenic bacteria that manipulate host inflammation as part of their colonization strategy possess CZB-regulated diguanylate cyclases and chemoreceptors. Our findings suggest that CZB domains are zinc-sensitive regulators that allow host-associated bacteria to perceive host inflammation through reactivity with HOCl.

Selective Imaging of HClO in the Liver Tissue In Vivo Using a Near-infrared Hepatocyte-specific Fluorescent Probe

Liver injury is typified by an inflammatory response. Hypochlorous acid (HClO), an important endogenous reactive oxygen species, is regarded as a biomarker associated with liver injury. Near-infrared (NIR) fluorescent probes with the advantage of deep tissue penetrating and low auto-fluorescence interference are more suitable for bioimaging in vivo. Thus, in this work, we designed and synthesized a novel NIR hepatocyte-specific fluorescent probe named NHF. The probe NHF showed fast response (<3 s), large spectral variation, and good selectivity to trace HClO in buffer solution. By employing N-acetylgalactosamine (GalNAc) as the targeting ligand, probe NHF can be actively delivered to the liver tissue of zebrafish and mice. It is important that probe NHF is the first NIR hepatocyte-specific fluorescent probe, which successfully visualized the up-regulation of endogenous HClO in the oxygen-glucose deprivation/reperfusion (OGD/R) model HepG2 cells and dynamically monitored APAP-induced endogenous HClO in the liver tissue of zebrafish and mice.

Myeloperoxidase Inhibitory and Antioxidant Activities of (E)-2-Hydroxy-α-aminocinnamic Acids Obtained through Microwave-Assisted Synthesis

Myeloperoxidase (MPO) is an enzyme present in human neutrophils, whose main role is to provide defenses against invading pathogens. However, highly reactive oxygen species (ROS), such as HOCl, are generated from MPO activity, leading to chronic diseases. Herein, we report the microwave-assisted synthesis of a new series of stable (E)-(2-hydroxy)-α-aminocinnamic acids, in good yields, which are structurally analogous to the natural products (Z)-2-hydroxycinnamic acids. The radical scavenging activity (RSA), MPO inhibitory activity and cytotoxicity of the reported compounds were evaluated. The hydroxy derivatives showed the most potent RSA, reducing the presence of DPPH and ABTS radicals by 77% at 0.32 mM and 100% at 0.04 mM, respectively. Their mechanism of action was modeled with BDE_OH, IP and ΔE_H-L theoretical calculations at the B3LYP/6 − 31 + G(d,p) level. Compounds showed in vitro inhibitory activity of MPO with IC₅₀ values comparable to indomethacin and 5-ASA, but cytotoxicities below 15% at 100–200 µM. Docking calculations revealed that they reach the amino acid residues present in the distal cavity of the MPO active site, where both the amino and carboxylic acid groups of the α-aminopropenoic acid arm are structural requirements for anchoring. (E)-2-hydroxy-α-aminocinnamic acids have been synthesized for the first time with a reliable method and their antioxidant properties demonstrated.

Bioshell calcium oxide (BiSCaO) for cleansing and healing Pseudomonas aeruginosa-infected wounds in hairless rats

BACKGROUND

Scallop shell powder is called bioshell calcium oxide (BiSCaO), which is known to possess deodorizing properties and broad antimicrobial activity against various pathogenic microbes, including viruses, bacteria, spores, and fungi.

OBJECTIVE

This study aims to investigate the applications of BiSCaO suspension cleansing in clinical situations, for instance for the prevention and treatment of infections in chronic wounds in healing-impaired patients, without delaying wound healing.

METHODS

The bactericidal activities of 1000 ppm BiSCaO suspension; 500 ppm hypochlorous acid; 1000 ppm povidone iodine; and saline were compared to evaluate in vivo disinfection and healing of Pseudomonas aeruginosa-infected wounds in hairless rats.

RESULTS

Cleansing of the infected wounds with BiSCaO suspension daily for 3 days significantly enhanced wound healing and reduced the in vivo bacterial counts, in comparison to hypochlorous acid, povidone iodine, and saline. Furthermore, histological examinations showed significantly advanced granulation tissue and capillary formation in the wounds cleansed with BiSCaO suspension than in those cleansed with the other solutions.

CONCLUSIONS

This study suggested that the possibility of using BiSCaO suspension as a disinfectant for infected wounds and limiting disinfection to 3 days may be sufficient to avoid the negative effects on wound repair.

The Safety and Antimicrobial Properties of Stabilized Hypochlorous Acid in Acetic Acid Buffer for the Treatment of Acute Wounds-a Human Pilot Study and In Vitro Data

Acute wounds may require cleansing to reduce the risk of infection. Stabilized hypochlorous acid in acetic buffer (HOCl + buffer) is a novel wound irrigation solution with antimicrobial properties. We performed a first-in-man, prospective, open-label pilot study to document preliminary safety and performance in the treatment of acute wounds. The study enrolled 12 subjects scheduled for a split-skin graft transplantation, where the donor site was used as a model of an acute wound. The treatment time was 75 s, given on 6 occasions. A total of 7 adverse events were regarded as related to the treatment; all registered as pain during the procedure for 2 subjects. One subject had a wound infection at the donor site. The mean colony-forming unit (CFU) decreased by 41% after the treatment, and the mean epithelialization was 96% on both days 14 (standard deviation [SD] 8%) and 21 (SD 10%). The study provides preliminary support for the safety, well-tolerance, and efficacy of HOCl + buffer for acute wounds. The pain was frequent although resolved quickly. Excellent wound healing and satisfying antimicrobial properties were observed. A subsequent in vitro biofilm study also indicated good antimicrobial activity against Pseudomonas aeruginosa with a 96% mean reduction of CFU, when used for a treatment duration of 15 min (P < .0001), and a 50% decrease for Staphylococcus aureus (P = .1010). Future larger studies are needed to evaluate the safety and performance of HOCl + buffer in acute wounds, including the promising antimicrobial effect by prolonged treatment on bacterial biofilms.

Argon Plasma Exposure Augments Costimulatory Ligands and Cytokine Release in Human Monocyte-Derived Dendritic Cells

Cold physical plasma is a partially ionized gas expelling many reactive oxygen and nitrogen species (ROS/RNS). Several plasma devices have been licensed for medical use in dermatology, and recent experimental studies suggest their putative role in cancer treatment. In cancer therapies with an immunological dimension, successful antigen presentation and inflammation modulation is a key hallmark to elicit antitumor immunity. Dendritic cells (DCs) are critical for this task. However, the inflammatory consequences of DCs following plasma exposure are unknown. To this end, human monocyte-derived DCs (moDCs) were expanded from isolated human primary monocytes; exposed to plasma; and their metabolic activity, surface marker expression, and cytokine profiles were analyzed. As controls, hydrogen peroxide, hypochlorous acid, and peroxynitrite were used. Among all types of ROS/RNS-mediated treatments, plasma exposure exerted the most notable increase of activation markers at 24 h such as CD25, CD40, and CD83 known to be crucial for T cell costimulation. Moreover, the treatments increased interleukin (IL)-1α, IL-6, and IL-23. Altogether, this study suggests plasma treatment augmenting costimulatory ligand and cytokine expression in human moDCs, which might exert beneficial effects in the tumor microenvironment.

Elimination of Oxygen Interference in the Electrochemical Detection of Monochloramine, Using In Situ pH Control at Interdigitated Electrodes

Disinfection of water systems by chloramination is a method frequently used in North America as an alternative to chlorination. In such a case, monochloramine is used as the primary chlorine source for disinfection. Regular monitoring of the residual concentrations of this species is essential to ensure adequate disinfection. An amperometric sensor for monochloramine would provide fast, reagent-free analysis; however, the presence of dissolved oxygen in water complicates sensor development. In this work, we used in-situ pH control as a method to eliminate oxygen interference by conversion of monochloramine to dichloramine. Unlike monochloramine, the electrochemical reduction of dichloramine occurs outside the oxygen reduction potential window and is therefore not affected by the oxygen concentration. Potential sweep methods were used to investigate the conversion of monochloramine to dichloramine at pH 3. The pH control method was used to calibrate monochloramine concentrations between 1 and 10 ppm, with a detection limit of 0.03 ppm. Tests were carried out in high alkalinity samples, wherein it was found that the sensitivity of this method effectively remained unchanged. Monochloramine was also quantified in the presence of common interferents (copper, phosphate, and iron) which also had no significant impact on the analysis.

Impact of a Whole-Room Atomizing Disinfection System on Healthcare Surface Contamination, Pathogen Transfer, and Labor Efficiency

Supplemental Digital Content is available in the text.

Healthcare surfaces contribute to nosocomial disease transmission. Studies show that despite standard guidelines and practices for cleaning and disinfection, secondary infection spread among healthcare workers and patients is common in ICUs. Manual terminal cleaning practices in healthcare are subject to highly variable results due to differences in training, compliance, and other inherent complexities. Standard cleaning practices combined with no-touch disinfecting technologies, however, may significantly lower nosocomial infection rates. The objective of this study was to evaluate the efficacy of a whole-room, no-touch disinfection intervention to reduce the concentration and cross-contamination of surface bacteria when used in tandem with manual cleaning protocols.

An Integrated HOCl-Producing E-Scaffold Is Active against Monomicrobial and Polymicrobial Biofilms

Oxidizing agents like hypochlorous acid (HOCl) have antimicrobial activity. We developed an integrated electrochemical scaffold, or e-scaffold, that delivers a continuous low dose of HOCl aimed at targeting microbial biofilms without exceeding concentrations toxic to humans as a prototype of a device being developed to treat wound infections in humans. In this work, we tested the device against 33 isolates of bacteria (including isolates with acquired antibiotic resistance) grown as in vitro biofilms alongside 12 combinations of dual-species in vitro biofilms. Biofilms were grown on the bottoms of 12-well plates for 24 h. An integrated e-scaffold was placed atop each biofilm and polarized at 1.5 V for 1, 2, or 4 h. HOCl was produced electrochemically by oxidizing chloride ions (Cl^-) in solution to chlorine (Cl₂); dissolved Cl₂ spontaneously dissociates in water to produce HOCl. The cumulative concentration of HOCl produced at the working electrode in each well was estimated to be 7.89, 13.46, and 29.50 mM after 1, 2, and 4 h of polarization, respectively. Four hours of polarization caused an average reduction of 6.13 log₁₀ CFU/cm² (±1.99 log₁₀ CFU/cm²) of viable cell counts of monospecies biofilms and 5.53 log₁₀ CFU/cm² (±2.31 log₁₀ CFU/cm²) for the 12 dual-species biofilms studied. The described integrated e-scaffold reduces viable bacterial cell counts in biofilms formed by an array of antibiotic-susceptible and -resistant bacteria alone and in combination.

Assembly of Water-soluble AIE-active Fluorescent Organic Nanoparticles for Ratiometric Detection of Hypochlorite in Living Cells

Hypochlorous acid (HOCl) plays a crucial role in many physiological processes and is widely used as bleach, deodorant and fungicide. In this work, we designed an amphiphilic hydrazone fluorescent molecule THG-1 containing hydrophilic sugar units and hydrophobic tetraphenylethylene unit for ratiometric detection of HOCl with high sensitivity and excellent selectivity based on HOCl-triggered hydrolyzation reaction and aggregation-induced emission (AIE) effect. The detection mechanism was verified by liquid chromatograph mass spectrometry experiments and scanning electron microscope (SEM) tests. Contrast experiments revealed that the numbers of lactose unit and hydrazone linker were essential for assembly of THG-1 and detection of HOCl. In addition, THG-1 was successfully used for imaging of exogenous and endogenous HOCl in living cells.