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Tan L, Ma R, Katz AJ, Levi N. Farnesol repurposing for prevention and treatment of Acinetobacter baumannii biofilms. Biofilm 2024; 7:100198. [PMID: 38706984 PMCID: PMC11066513 DOI: 10.1016/j.bioflm.2024.100198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/07/2024] Open
Abstract
Acinetobacter baumannii has emerged as a multidrug-resistant (MDR) superbug by causing severe infections, with high mortality rates. The ability of A. baumannii to form biofilms significantly contributes to its persistence in diverse environmental and hospital settings. Here we report that farnesol, an FDA-approved commercial cosmetic and flavoring agent, demonstrates efficacy for both inhibition of biofilm formation, and disruption of established A. baumannii biofilms. Moreover, no resistance to farnesol was observed even after prolonged culture in the presence of sub-inhibitory farnesol doses. Farnesol combats A. baumannii biofilms by direct killing, while also facilitating biofilm detachment. Furthermore, farnesol was safe, and effective, for both prevention and treatment of A. baumannii biofilms in an ex vivo burned human skin model. Since current treatment options for A. baumannii biofilm infections were mainly counted on the combination therapy of last-resort antibiotics, and clearly non-sustainable due to robust MDR phenotype of A. baumannii, we propose that farnesol alone can be repurposed as a highly effective agent for both preventing and treating life-threating biofilm-associated infections of A. baumannii due to its proven safety, convenient topical delivery, and excellent efficiency, plus its superiority of evading resistance development.
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Affiliation(s)
- Li Tan
- Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Rong Ma
- Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Adam J. Katz
- Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Nicole Levi
- Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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2
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Tan L, Ma R, Reeves T, Katz AJ, Levi N. Repurposing Farnesol for Combating Drug-Resistant and Persistent Single and Polymicrobial Biofilms. Antibiotics (Basel) 2024; 13:350. [PMID: 38667026 PMCID: PMC11047559 DOI: 10.3390/antibiotics13040350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024] Open
Abstract
Biofilm-associated infections caused by drug-resistant and persistent bacteria remain a significant clinical challenge. Here we report that farnesol, commercially available as a cosmetic and flavoring agent, shows significant anti-biofilm properties when dissolved in ethanol using a proprietary formulation emulsion technique. Farnesol in the new formulation inhibits biofilm formation and disrupts established biofilms for Gram-positive Staphylococcus aureus and Gram-negative Pseudomonas aeruginosa, including their polymicrobial biofilms, and, moreover, kills S. aureus persister cells that have developed tolerance to antibiotics. No resistance to farnesol was observed for S. aureus after twenty continuous passages. Farnesol combats biofilms by direct killing, while also facilitating biofilm detachment. Furthermore, farnesol was safe and effective for preventing and treating biofilm-associated infections of both types of bacteria in an ex vivo burned human skin model. These data suggest that farnesol in the new formulation is an effective broad-spectrum anti-biofilm agent with promising clinical potential. Due to its established safety, low-cost, versatility, and excellent efficacy-including ability to reduce persistent and resistant microbial populations-farnesol in the proprietary formulation represents a compelling transformative, translational, and commercial platform for addressing many unsolved clinical challenges.
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Affiliation(s)
- Li Tan
- Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (L.T.); (A.J.K.)
| | - Rong Ma
- Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (L.T.); (A.J.K.)
| | - Tony Reeves
- Department of Internal Medicine, Section on Molecular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Adam J. Katz
- Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (L.T.); (A.J.K.)
| | - Nicole Levi
- Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (L.T.); (A.J.K.)
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3
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Stevenson P, Marguet M, Regulski M. Biofilm and Hospital-Acquired Infections in Older Adults. Crit Care Nurs Clin North Am 2023; 35:375-391. [PMID: 37838413 DOI: 10.1016/j.cnc.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Biofilm infections are a serious threat to public health, resistant to traditional treatments and host immune defenses. Biofilm infections are often polymicrobial, related to chronic wounds, medical devices (eg, knee replacements, catheters, tubes, contact lenses, or prosthetic valves) and chronic recurring diseases. Biofilms are more complex than nonadhered planktonic bacteria and produce a structure that prevents damage to the bacteria within the biofilm structure. The structure provides a hidden route to feed and nurture the bacteria allowing for ongoing spread of the bacteria.
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Affiliation(s)
- Patricia Stevenson
- Next Science™ LLC, 10550 Deerwood Park Boulevard, Suite 300, Jacksonville, FL 32256, USA.
| | - Melissa Marguet
- Next Science™ LLC, 10550 Deerwood Park Boulevard, Suite 300, Jacksonville, FL 32256, USA
| | - Matthew Regulski
- Next Science™ LLC, 10550 Deerwood Park Boulevard, Suite 300, Jacksonville, FL 32256, USA; The Wound Institute of Ocean County, 54 Bey Lea Road Tom's River, NJ 08759, USA
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4
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Doan L, Tran K. Relationship between the Polymer Blend Using Chitosan, Polyethylene Glycol, Polyvinyl Alcohol, Polyvinylpyrrolidone, and Antimicrobial Activities against Staphylococcus aureus. Pharmaceutics 2023; 15:2453. [PMID: 37896214 PMCID: PMC10610092 DOI: 10.3390/pharmaceutics15102453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
The findings from Pareto charts, main effect plots, and interaction plots demonstrate the importance of polymer concentration. Increasing concentration improves the inhibition percentage and decreases the MIC50. However, the primary factor that influences these changes is chitosan (CS). Additionally, the interaction between CS and PVP, along with other polymers, plays a crucial role in achieving better antimicrobial effects. These results enhance our understanding of the antimicrobial properties of the studied polymers and offer valuable insights for developing effective antimicrobial formulations. The MIC50 value of M1-M16 was at a polymer percentage of 12.5%. At 12.5% polymer percentage, with the limits of [PVA], [PEG], and [PVP] being 0.002-0.004 g/mL and [CS] being 0.001-0.002 g/mL, using the 2-level full factorial method, the inhibition percentage is equal to 174.1 - 27,812 PVA - 18,561 PVP - 25,960 PEG - 38,752 CS + 9,263,047 PVA*PVP + 10,430,763 PVA*PEG + 15,397,157 PVA*CS + 7,088,313 PVP*PEG + 7,841,221 PVP*CS + 14,228,046 PEG*CS - 3,367,292,860 PVA*PVP*PEG - 5,671,998,721 PVA*PVP*CS - 6,619,041,275 PVA*PEG*CS - 3,917,095,529 PVP*PEG*CS + 2,273,661,969,470 PVA*PVP*PEG*CS. Theoretically, the most economical concentrations of PVA, PVP, PEG, and CS are 0.002, 0.002, 0.002, and 0.001 mg/mL at a concentration of 12.5% to reach an inhibition percentage of 99.162%, which coincides with the MBC value.
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Affiliation(s)
- Linh Doan
- School of Chemical and Environmental Engineering, International University—Vietnam National University, Ho Chi Minh City 70000, Vietnam
- Nanomaterials Engineering Research & Development (NERD) Laboratory, International University—Vietnam National University, Ho Chi Minh City 70000, Vietnam
| | - Khoa Tran
- School of Chemical and Environmental Engineering, International University—Vietnam National University, Ho Chi Minh City 70000, Vietnam
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5
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Regulski M, Myntti MF, James GA. Anti-Biofilm Efficacy of Commonly Used Wound Care Products in In Vitro Settings. Antibiotics (Basel) 2023; 12:antibiotics12030536. [PMID: 36978402 PMCID: PMC10044339 DOI: 10.3390/antibiotics12030536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/24/2023] [Accepted: 03/02/2023] [Indexed: 03/30/2023] Open
Abstract
Considering the prevalence and pathogenicity of biofilms in wounds, this study was designed to evaluate the anti-biofilm capabilities of eight commercially available wound care products using established in vitro assays for biofilms. The products evaluated included dressings with multiple delivery formats for ionic silver including nanocrystalline, gelling fibers, polyurethane (PU) foam, and polymer matrix. Additionally, non-silver-based products including an extracellular polymeric substance (EPS)-dissolving antimicrobial wound gel (BDWG), a collagenase-based debriding ointment and a fish skin-based skin substitute were also evaluated. The products were evaluated on Staphylococcus aureus and Pseudomonas aeruginosa mixed-species biofilms grown using colony drip flow reactor (CDFR) and standard drip flow reactor (DFR) methodologies. Anti-biofilm efficacy was measured by viable plate counts and confocal scanning laser microscopy (CSLM). Four of the eight wound care products tested were efficacious in inhibiting growth of new biofilm when compared with untreated controls. These four products were further evaluated against mature biofilms. BDWG was the only product that achieved greater than 2-log growth reduction (5.88 and 6.58 for S. aureus and P. aeruginosa, respectively) of a mature biofilm. Evaluating both biofilm prevention and mature biofilm disruption capacity is important to a comprehensive understanding of the anti-biofilm efficacy of wound care products.
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Affiliation(s)
- Matthew Regulski
- Wound Care Institute of Ocean County, 54 Bey Lea Road, Toms River, NJ 08753, USA
| | - Matthew F Myntti
- Next Science® LLC, 10550 Deerwood Park Blvd, Suite 300, Jacksonville, FL 32256, USA
| | - Garth A James
- Center for Biofilm Engineering, Montana State University, 366 Barnard Hall, Bozeman, MT 59717, USA
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Vimal A, Kumar A, Kumar A. Inhibitory interaction and pharmacological analyses of berries phenolics against Listeria monocytogenes virulent protein internalin B. WORLD JOURNAL OF TRADITIONAL CHINESE MEDICINE 2023. [DOI: 10.4103/2311-8571.364413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Araviiskaia E, Pincelli C, Sparavigna A, Luger T. The Role of a Novel Generation of Emollients, 'Emollients Plus', in Atopic Dermatitis. Clin Cosmet Investig Dermatol 2022; 15:2705-2719. [PMID: 36545500 PMCID: PMC9763050 DOI: 10.2147/ccid.s389697] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/26/2022] [Indexed: 12/15/2022]
Abstract
Emollients are the mainstay maintenance treatment for atopic dermatitis (AD). A novel generation of emollients, 'emollients plus', containing active, non-medicated substances, has softened the distinction between emollients and topical drugs. A literature search for selected key words was performed using PubMed. Additional papers were identified based on author expertise. Whilst the inclusion of five components of an ideal emollient has been proposed, no such consensus exists for emollients plus and they can vary markedly in their composition and modes of action for AD treatment. This could have a profound effect on their clinical efficacy. The efficacy of emollients plus in restoring and maintaining skin barrier function has been demonstrated on multiple levels, with evidence reported for their effects on the physical and biochemical, microbial, immunological, and neurosensory barriers. When selecting an appropriate AD treatment approach, the safety profiles of the available topical therapies must be carefully considered. There are several proposed treatment approaches for AD, including preventive, proactive, intermittent, and synergistic approaches. Emollients plus may be effective not only as maintenance therapy for AD, but also when used synergistically with anti-inflammatory pharmacological therapies.
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Affiliation(s)
- Elena Araviiskaia
- Department of Dermatology and Venereal Diseases, First Pavlov State Medical University of St Petersburg, St Petersburg, Russia
| | - Carlo Pincelli
- DermoLab, Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Adele Sparavigna
- Derming Clinical Research and Bioengineering Institute, Milan, Italy
| | - Thomas Luger
- Department of Dermatology, University of Munster, Munster, Germany,Correspondence: Thomas Luger, Dermatology Clinic, University of Münster, Von-Esmarch-Straẞe 58, Münster, 48149, Germany, Email
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8
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Shariati A, Vesal S, Khoshbayan A, Goudarzi P, Darban-Sarokhalil D, Razavi S, Didehdar M, Chegini Z. Novel strategies for inhibition of bacterial biofilm in chronic rhinosinusitis. J Appl Microbiol 2021; 132:2531-2546. [PMID: 34856045 DOI: 10.1111/jam.15398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/18/2021] [Accepted: 11/29/2021] [Indexed: 12/27/2022]
Abstract
An important role has been recently reported for bacterial biofilm in the pathophysiology of chronic diseases, such as chronic rhinosinusitis (CRS). CRS, affecting sinonasal mucosa, is a persistent inflammatory condition with a high prevalence around the world. Although the exact pathological mechanism of this disease has not been elicited yet, biofilm formation is known to lead to a more significant symptom burden and major objective clinical indicators. The high prevalence of multidrug-resistant bacteria has severely restricted the application of antibiotics in recent years. Furthermore, systemic antibiotic therapy, on top of its insufficient concentration to eradicate bacteria in the sinonasal biofilm, often causes toxicity, antibiotic resistance, and an effect on the natural microbiota, in patients. Thus, coming up with alternative therapeutic options instead of systemic antibiotic therapy is emphasized in the treatment of bacterial biofilm in CRS patients. The use of topical antibiotic therapy and antibiotic eluting sinus stents that induce higher antibiotic concentration, and decrease side effects could be helpful. Besides, recent research recognized that various natural products, nitric oxide, and bacteriophage therapy, in addition to the hindered biofilm formation, could degrade the established bacterial biofilm. However, despite these improvements, new antibacterial agents and CRS biofilm interactions are complicated and need extensive research. Finally, most studies were performed in vitro, and more preclinical animal models and human studies are required to confirm the collected data. The present review is specifically discussing potential therapeutic strategies for the treatment of bacterial biofilm in CRS patients.
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Affiliation(s)
- Aref Shariati
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Soheil Vesal
- Department of Molecular Genetics, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
| | - Amin Khoshbayan
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Parnian Goudarzi
- Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam Razavi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Didehdar
- Department of Medical Parasitology and Mycology, Arak University of Medical Sciences, Arak, Iran
| | - Zahra Chegini
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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9
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Costa AF, Silva LDC, Amaral AC. Farnesol: An approach on biofilms and nanotechnology. Med Mycol 2021; 59:958-969. [PMID: 33877362 DOI: 10.1093/mmy/myab020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/04/2021] [Accepted: 03/19/2021] [Indexed: 12/19/2022] Open
Abstract
Biofilms are important virulence factor in infections caused by microorganisms because of its complex structure, which provide resistance to conventional antimicrobials. Strategies involving the use of molecules capable of inhibiting their formation and also act synergistically with conventional drugs have been explored. Farnesol is a molecule present in essential oils and produced by Candida albicans as a quorum sensing component. This sesquiterpene presents inhibitory properties in the formation of microbial biofilms and synergism with antimicrobials used in clinical practice, and can be exploited even for eradication of biofilms formed by drug-resistant microorganisms. Despite this, farnesol has physical and chemical characteristics that can limit its use, such as high hydrophobicity and volatility. Therefore, nanotechnology may represent an option to improve the efficiency of this molecule in high complex environments such as biofilms. Nanostructured systems present important results in the improvement of treatment with different commercial drugs and molecules with therapeutic or preventive potential. The formation of nanoparticles offers advantages such as protection of the incorporated drugs against degradation, improved biodistribution and residence time in specific treatment sites. The combination of farnesol with nanotechnology may be promising for the development of more effective antibiofilm therapies, as it can improve its solubility, reduce volatility, and increase bioavailability. This review summarizes existing data about farnesol, its action on biofilms, and discusses its encapsulation in nanostructured systems. LAY SUMMARY Farnesol is a natural compound that inhibits the formation of biofilms from different microbial species. The encapsulation of this molecule in nanoparticles is a promising alternative for the development of more effective therapies against biofilms.
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Affiliation(s)
- Adelaide Fernandes Costa
- Biological Science Institute, Universidade Federal de Goiás, Goiânia, 74690-900, Brazil.,Biotechnology, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, 74605-050, Brazil
| | - Lívia do Carmo Silva
- Biotechnology, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, 74605-050, Brazil
| | - Andre Correa Amaral
- Biotechnology, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, 74605-050, Brazil
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Quadri M, Lotti R, Bonzano L, Ciardo S, Guanti MB, Pellacani G, Pincelli C, Marconi A. A Novel Multi-Action Emollient Plus Cream Improves Skin Barrier Function in Patients with Atopic Dermatitis: In vitro and Clinical Evidence. Skin Pharmacol Physiol 2021; 34:8-18. [PMID: 33601378 DOI: 10.1159/000513055] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/13/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Emollients capable of restoring the skin barrier function would extend their role beyond basic maintenance therapy in atopic dermatitis (AD). OBJECTIVES Investigate the effect of a novel emollient plus cream (EC; Dermoflan®) on the skin barrier in vitro and in patients with mild-to-moderate AD. METHODS The effect of EC on the skin barrier recovery was evaluated using a tape-stripping (TS) model. After TS, organ cultures were treated with EC (undiluted or diluted 1:1 with water) and analyzed at 18-120 h using hematoxylin and eosin, Oil Red O, immunohistochemical, and immunofluorescent techniques. In a double-blind, randomized study, EC or placebo was applied once daily for 2 months to antecubital folds of the upper and lower limbs of patients with mild-to-moderate AD in clinical remission. Epidermal thickness, vascularization, and epidermal hydration were assessed by optical coherence tomography and corneometry, respectively, at baseline, and 1 and 2 months following treatment initiation. RESULTS Following TS, EC treatment significantly increased epidermal thickness and lipid content versus diluent in the skin organ culture, as well as claudin-1, involucrin, and caspase-14 expression, suggesting skin barrier repair. EC treatment also decreased keratin-16 expression and increased levels of Toll-like receptors 1 and 2 versus diluent, suggesting involvement in regulating the epidermal immune response. In 20 patients randomized 1:1 to EC or placebo, EC treatment at the elbow fold/popliteal fossa significantly decreased epidermal thickness after 2 months, and the number of blood vessels at the elbow fold after 1 and 2 months, versus placebo. EC significantly improved the skin hydration after 2 months versus baseline. CONCLUSIONS This novel multi-action EC may help to restore epidermal homeostasis and improve the skin of patients with AD. Results indicate that this novel multi-action EC could be a valid adjuvant therapy in patients with AD. Key Message: Novel multi-action emollient cream helps to restore epidermal homeostasis and improves the skin affected by AD.
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Affiliation(s)
- Marika Quadri
- Department of Surgical, Medical, Dental, and Morphological Sciences, Dermolab, University of Modena and Reggio Emilia, Modena, Italy,
| | - Roberta Lotti
- Department of Surgical, Medical, Dental, and Morphological Sciences, Dermolab, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Bonzano
- Department of Surgical, Medical, Dental, and Morphological Sciences, Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvana Ciardo
- Department of Surgical, Medical, Dental, and Morphological Sciences, Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Mario Bruno Guanti
- Department of Surgical, Medical, Dental, and Morphological Sciences, Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- Department of Surgical, Medical, Dental, and Morphological Sciences, Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Pincelli
- Department of Surgical, Medical, Dental, and Morphological Sciences, Dermolab, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandra Marconi
- Department of Surgical, Medical, Dental, and Morphological Sciences, Dermolab, University of Modena and Reggio Emilia, Modena, Italy
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Gonzalez T, Stevens ML, Baatyrbek kyzy A, Alarcon R, He H, Kroner JW, Spagna D, Grashel B, Sidler E, Martin LJ, Biagini Myers JM, Khurana Hershey GK, Herr AB. Biofilm propensity of Staphylococcus aureus skin isolates is associated with increased atopic dermatitis severity and barrier dysfunction in the MPAACH pediatric cohort. Allergy 2021; 76:302-313. [PMID: 32640045 DOI: 10.1111/all.14489] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 04/30/2020] [Accepted: 05/24/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) patients are often colonized with Staphylococcus aureus, and staphylococcal biofilms have been reported on adult AD skin lesions. The commensal S epidermidis can antagonize S aureus, although its role in AD is unclear. We sought to characterize S aureus and S epidermidis colonization and biofilm propensity and determine their associations with AD severity, barrier function, and epidermal gene expression in the first US early-life cohort of children with AD, the Mechanisms of Progression of Atopic Dermatitis to Asthma in Children (MPAACH). METHODS The biofilm propensity of staphylococcal isolates was assessed by crystal violet assays. Gene expression of filaggrin and antimicrobial alarmins S100A8 and S100A9 was measured in keratinocyte RNA extracted from skin tape strips. Staphylococcal biofilms sampled from MPAACH skin were visualized using scanning electron microscopy. RESULTS Sixty-two percent of staphylococcal isolates (sampled from 400 subjects) formed moderate/strong biofilms. Sixty-eight percent of subjects co-colonized with both staphylococcal species exhibited strains that formed cooperative mixed-species biofilms. Scanning electron microscopy verified the presence of staphylococcal biofilms on the skin of MPAACH children. Staphylococcus aureus strains showing higher relative biofilm propensity compared with S epidermidis were associated with increased AD severity (P = .03) and increased lesional and nonlesional transepidermal water loss (P = .01, P = .03). CONCLUSIONS Our data suggest a pathogenic role for S aureus biofilms in AD. We found that strain-level variation in staphylococcal isolates governs the interactions between S epidermidis and S aureus and that the balance between these two species, and their biofilm propensity, has important implications for AD.
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Affiliation(s)
- Tammy Gonzalez
- Division of Immunobiology Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - Mariana L. Stevens
- Division of Asthma Research Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - Asel Baatyrbek kyzy
- Division of Asthma Research Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - Rosario Alarcon
- Division of Asthma Research Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - Hua He
- Division of Human Genetics Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - John W. Kroner
- Division of Asthma Research Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - Daniel Spagna
- Division of Asthma Research Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - Brittany Grashel
- Division of Asthma Research Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - Elaine Sidler
- Division of Immunobiology Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - Lisa J. Martin
- Division of Human Genetics Cincinnati Children's Hospital Medical Center Cincinnati OH USA
- Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH USA
| | - Jocelyn M. Biagini Myers
- Division of Asthma Research Cincinnati Children's Hospital Medical Center Cincinnati OH USA
- Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH USA
| | - Gurjit K. Khurana Hershey
- Division of Asthma Research Cincinnati Children's Hospital Medical Center Cincinnati OH USA
- Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH USA
- Division of Allergy and Immunology Cincinnati Children's Hospital Medical Center Cincinnati OH USA
| | - Andrew B. Herr
- Division of Immunobiology Cincinnati Children's Hospital Medical Center Cincinnati OH USA
- Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH USA
- Division of Infectious Diseases Cincinnati Children's Hospital Medical Center Cincinnati OH USA
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12
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Prebiotic Combinations Effects on the Colonization of Staphylococcal Skin Strains. Microorganisms 2020; 9:microorganisms9010037. [PMID: 33374268 PMCID: PMC7824076 DOI: 10.3390/microorganisms9010037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 01/16/2023] Open
Abstract
Background: An unbalanced skin microbiota due to an increase in pathogenic vs. commensal bacteria can be efficiently tackled by using prebiotics. The aim of this work was to identify novel prebiotic combinations by exerting species-specific action between S. aureus and S. epidermidis strains. Methods: First, the antimicrobial/antibiofilm effect of Xylitol-XYL and Galacto-OligoSaccharides–GOS combined with each other at different concentrations (1, 2.5, 5%) against S. aureus and S. epidermidis clinical strains was evaluated in time. Second, the most species-specific concentration was used to combine XYL with Fructo-OligoSaccharides–FOS, IsoMalto-Oligosaccharides–IMO, ArabinoGaLactan–LAG, inulin, dextran. Experiments were performed by OD600 detection, biomass quantification and LIVE/DEAD staining. Results: 1% XYL + 1% GOS showed the best species-specific action with an immediate antibacterial/antibiofilm action against S. aureus strains (up to 34.54% ± 5.35/64.68% ± 4.77) without a relevant effect on S. epidermidis. Among the other prebiotic formulations, 1% XYL plus 1% FOS (up to 49.17% ± 21.46/37.59% ± 6.34) or 1% IMO (up to 41.28% ± 4.88/36.70% ± 10.03) or 1% LAG (up to 38.21% ± 5.31/83.06% ± 5.11) showed antimicrobial/antibiofilm effects similar to 1% XYL+1% GOS. For all tested formulations, a prevalent bacteriostatic effect in the planktonic phase and a general reduction of S. aureus biofilm formation without loss of viability were recorded. Conclusion: The combinations of 1% XYL with 1% GOS or 1% FOS or 1% IMO or 1% LAG may help to control the balance of skin microbiota, representing good candidates for topic formulations.
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13
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A New Benchmark to Determine What Healthy Western Skin Looks Like in Terms of Biodiversity Using Standardised Methodology. COSMETICS 2020. [DOI: 10.3390/cosmetics7040079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
A significant loss of microbial biodiversity on the skin has been linked to an increased prevalence of skin problems in the western world. The primary objective of this study was to obtain a benchmark value for the microbial diversity found on healthy western skin, using the Chao1 index. This benchmark was used to update our 2017 skin health measuring mechanism in line with standardised methodology. It used 50 human participants from Graz in Austria and at a read depth of 6600 sequences, we found the average Chao1 diversity to be ~180, with upper and lower quartiles of ~208 and ~150, respectively. Previous work with a larger sample size was unsatisfactory to use as a benchmark because different diversity indices and evaluation methodologies were used. The Medical University of Graz used the most recent version of the Chao1 index to obtain diversity results. Because of this study, we can transfer other benchmarks of skin microbiome diversity to the methodology used in this work from our 2017 study, such as “unhealthy western skin” and “caveman/perfect skin”. This could aid with the diagnostic assessment of susceptibility to cutaneous conditions or diseases and treatment. We also investigated the effect of sex and age, which are two known skin microbiome affecting factors. Although no statistical significance is seen for sex- and age-related changes in diversity, there appear to be changes related to both. Our preliminary results (10 in each of the five age groups) show adults aged 28–37 have the highest average diversity, and adults aged 48–57 have the lowest average diversity. In future work, this could be improved by obtaining benchmark diversity values from a larger sample size for any age, sex, body site, and area of residence, to which subjects can be compared. These improvements could help to investigate the ultimate question regarding which environmental factors in the western world are the main cause of the huge rise in skin problems. This could lead to future restrictions of certain synthetic chemicals or products found to be particularly harmful to the skin.
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14
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George SMC, Karanovic S, Harrison DA, Rani A, Birnie AJ, Bath‐Hextall FJ, Ravenscroft JC, Williams HC. Interventions to reduce Staphylococcus aureus in the management of eczema. Cochrane Database Syst Rev 2019; 2019:CD003871. [PMID: 31684694 PMCID: PMC6818407 DOI: 10.1002/14651858.cd003871.pub3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Staphylococcus aureus (S. aureus) can cause secondary infection in eczema, and may promote inflammation in eczema that does not look infected. There is no standard intervention to reduce S. aureus burden in eczema. It is unclear whether antimicrobial treatments help eczema or promote bacterial resistance. This is an update of a 2008 Cochrane Review. OBJECTIVES To assess the effects of interventions to reduce S. aureus for treating eczema. SEARCH METHODS We updated our searches of the following databases to October 2018: Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase and LILACS. We searched five trials registers and three sets of conference proceedings. We checked references of trials and reviews for further relevant studies. We contacted pharmaceutical companies regarding ongoing and unpublished trials. SELECTION CRITERIA Randomised controlled trials of products intended to reduce S. aureus on the skin in people diagnosed with atopic eczema by a medical practitioner. Eligible comparators were a similar treatment regimen without the anti-staphylococcal agent. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Our key outcomes were participant- or assessor-rated global improvement in symptoms/signs, quality of life (QOL), severe adverse events requiring withdrawal, minor adverse events, and emergence of antibiotic-resistant micro-organisms. MAIN RESULTS We included 41 studies (1753 analysed participants) covering 10 treatment categories. Studies were conducted mainly in secondary care in Western Europe; North America; the Far East; and elsewhere. Twelve studies recruited children; four, adults; 19, both; and six, unclear. Fifty-nine per cent of the studies reported the mean age of participants (range: 1.1 to 34.6 years). Eczema severity ranged from mild to severe. Many studies did not report our primary outcomes. Treatment durations ranged from 10 minutes to 3 months; total study durations ranged from 15 weeks to 27 months. We considered 33 studies at high risk of bias in at least one domain. We present results for three key comparisons. All time point measurements were taken from baseline. We classed outcomes as short-term when treatment duration was less than four weeks, and long-term when treatment was given for more than four weeks. Fourteen studies evaluated topical steroid/antibiotic combinations compared to topical steroids alone (infective status: infected (two studies), not infected (four studies), unspecified (eight studies)). Topical steroid/antibiotic combinations may lead to slightly greater global improvement in good or excellent signs/symptoms than topical steroid alone at 6 to 28 days follow-up (risk ratio (RR) 1.10, 95% confidence interval (CI) 1.00 to 1.21; 224 participants; 3 studies, low-quality evidence). There is probably little or no difference between groups for QOL in children, at 14 days follow-up (mean difference (MD) -0.18, 95% CI -0.40 to 0.04; 42 participants; 1 study, moderate-quality evidence). The subsequent results for this comparison were based on very low-quality evidence, meaning we are uncertain of their validity: severe adverse events were rare (follow-up: between 6 to 28 days): both groups reported flare of dermatitis, worsening of the condition, and folliculitis (325 participants; 4 studies). There were fewer minor adverse events (e.g. flare, stinging, itch, folliculitis) in the combination group at 14 days follow-up (218 participants; 2 studies). One study reported antibiotic resistance in children at three months follow-up, with similar results between the groups (65 participants; 1 study). Four studies evaluated oral antibiotics compared to placebo (infective status: infected eczema (two studies), uninfected (one study), one study's participants had colonisation but no clinical infection). Oral antibiotics may make no difference in terms of good or excellent global improvement in infants and children at 14 to 28 days follow-up compared to placebo (RR 0.80; 95% CI 0.18 to 3.50; 75 participants; 2 studies, low-quality evidence). There is probably little or no difference between groups for QOL (in infants and children) at 14 days follow-up (MD 0.11, 95% CI -0.10 to 0.32, 45 participants, 1 study, moderate-quality evidence). The subsequent results for this comparison were based on very low-quality evidence, meaning we are uncertain of their validity: adverse events requiring treatment withdrawal between 14 to 28 days follow-up were very rare, but included eczema worsening (both groups), loose stools (antibiotic group), and Henoch-Schönlein purpura (placebo group) (4 studies, 199 participants). Minor adverse events, including nausea, vomiting, diarrhoea, and stomach and joint pains, at 28 days follow-up were also rare and generally low in both groups (1 study, 68 infants and children). Antibiotic resistance at 14 days was reported as similar in both groups (2 studies, 98 infants and children). Of five studies evaluating bleach baths compared to placebo (water) or bath emollient (infective status: uninfected (two studies), unspecified (three studies)), one reported global improvement and showed that bleach baths may make no difference when compared with placebo at one month follow-up (RR 0.78, 95% CI 0.37 to 1.63; 36 participants; low-quality evidence). One study showed there is probably little or no difference in QOL at 28 days follow-up when comparing bleach baths to placebo (MD 0.90, 95% CI -1.32 to 3.12) (80 infants and children; moderate-quality evidence). We are uncertain if the groups differ in the likelihood of treatment withdrawals due to adverse events at two months follow-up (only one dropout reported due to worsening itch (placebo group)) as the quality of evidence was very low (1 study, 42 participants). One study reported that five participants in each group experienced burning/stinging or dry skin at two months follow-up, so there may be no difference in minor adverse events between groups (RR 1.00, 95% CI 0.35 to 2.87, 36 participants, low-quality evidence). Very low-quality evidence means we are also uncertain if antibiotic resistance at four weeks follow-up is different between groups (1 study, 80 participants ≤ 18 years). AUTHORS' CONCLUSIONS We found insufficient evidence on the effects of anti-staphylococcal treatments for treating people with infected or uninfected eczema. Low-quality evidence, due to risk of bias, imprecise effect estimates and heterogeneity, made pooling of results difficult. Topical steroid/antibiotic combinations may be associated with possible small improvements in good or excellent signs/symptoms compared with topical steroid alone. High-quality trials evaluating efficacy, QOL, and antibiotic resistance are required.
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Affiliation(s)
- Susannah MC George
- Brighton and Sussex University Hospitals NHS Trust, Brighton General HospitalDepartment of DermatologyBrighton General Hospital, Elm GroveBrightonUKBN2 3EW
| | - Sanja Karanovic
- Queen Elizabeth Hospital BirminghamDepartment of DermatologyMindelsohn WayBirminghamUKB15 2TH
| | - David A Harrison
- Intensive Care National Audit & Research CentreNapier House24 High HolbornLondonUKWC1V 6AZ
| | - Anjna Rani
- Centre of Evidence Based Dermatology(c/o) Cochrane Skin GroupThe University of NottinghamRoom A103, King's Meadow Campus, Lenton LaneNottinghamUKNG7 2NR
| | - Andrew J Birnie
- East Kent Hospitals University Foundation NHS TrustDepartment of DermatologyKent & Canterbury HospitalEthelbert RoadCanterburyUKCT1 3NG
| | - Fiona J Bath‐Hextall
- University of NottinghamSchool of Health SciencesB Floor, South Block LinkQueens Medical CentreNottinghamUKNG7 2HA
| | - Jane C Ravenscroft
- Nottingham University Hospitals NHS TrustDermatologyDerby RoadQueen's Medical Centre CampusNottinghamUKNG7 2UH
| | - Hywel C Williams
- University of NottinghamCentre of Evidence Based DermatologyQueen's Medical CentreDerby RoadNottinghamUKNG7 2UH
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15
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Abstract
Wound care experts at the 2019 EWMA conference described the need to adopt biofilm-based wound care, the case for silver dressings, the importance of early intervention and the benefits of effective antibiofilm technologies. Camila Fronzo, JWC chief sub editor, summarises the main points.
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16
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de Araújo Delmondes G, Bezerra DS, de Queiroz Dias D, de Souza Borges A, Araújo IM, Lins da Cunha G, Bandeira PFR, Barbosa R, Melo Coutinho HD, Felipe CFB, Barbosa-Filho JM, Alencar de Menezes IR, Kerntopf MR. Toxicological and pharmacologic effects of farnesol (C15H26O): A descriptive systematic review. Food Chem Toxicol 2019; 129:169-200. [DOI: 10.1016/j.fct.2019.04.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/02/2019] [Accepted: 04/22/2019] [Indexed: 12/22/2022]
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17
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Pinto D, Sorbellini E, Marzani B, Rucco M, Giuliani G, Rinaldi F. Scalp bacterial shift in Alopecia areata. PLoS One 2019; 14:e0215206. [PMID: 30973913 PMCID: PMC6459526 DOI: 10.1371/journal.pone.0215206] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 03/28/2019] [Indexed: 12/22/2022] Open
Abstract
The role of microbial dysbiosis in scalp disease has been recently hypothesized. However, little information is available with regards to the association between microbial population on the scalp and hair diseases related to hair growth. Here we investigated bacterial communities in healthy and Alopecia areata (AA) subjects. The analysis of bacterial distribution at the genus level highlighted an increase of Propionibacterium in AA subjects alongside a general decrease of Staphylococcus. Analysis of log Relative abundance of main bacterial species inhabiting the scalp showed a significant increase of Propionibacterium acnes in AA subjects compared to control ones. AA scalp condition is also associated with a significant decrease of Staphylococcus epidermidis relative abundance. No significant changes were found for Staphylococcus aureus. Therefore, data from sequencing profiling of the bacterial population strongly support a different microbial composition of the different area surrounded hair follicle from the epidermis to hypodermis, highlighting differences between normal and AA affected the scalp. Our results highlight, for the first time, the presence of a microbial shift on the scalp of patients suffering from AA and gives the basis for a larger and more complete study of microbial population involvement in hair disorders.
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Affiliation(s)
- Daniela Pinto
- Giuliani SpA, Milan, Italy
- Human Advanced Microbiome Project-HMAP, Milan, Italy
- International Hair Research Foundation (IHRF), Milan, Italy
| | - Elisabetta Sorbellini
- Human Advanced Microbiome Project-HMAP, Milan, Italy
- International Hair Research Foundation (IHRF), Milan, Italy
| | - Barbara Marzani
- Giuliani SpA, Milan, Italy
- Human Advanced Microbiome Project-HMAP, Milan, Italy
- International Hair Research Foundation (IHRF), Milan, Italy
| | | | - Giammaria Giuliani
- Giuliani SpA, Milan, Italy
- Human Advanced Microbiome Project-HMAP, Milan, Italy
| | - Fabio Rinaldi
- Giuliani SpA, Milan, Italy
- Human Advanced Microbiome Project-HMAP, Milan, Italy
- International Hair Research Foundation (IHRF), Milan, Italy
- * E-mail:
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18
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Páyer E, Szabó-Papp J, Ambrus L, Szöllősi AG, Andrási M, Dikstein S, Kemény L, Juhász I, Szegedi A, Bíró T, Oláh A. Beyond the physico-chemical barrier: Glycerol and xylitol markedly yet differentially alter gene expression profiles and modify signalling pathways in human epidermal keratinocytes. Exp Dermatol 2019. [PMID: 29520873 DOI: 10.1111/exd.13493] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Polyols (e.g. glycerol, xylitol) are implicated as moisturizers of the skin and other epithelial tissues. However, we lack information about their exact cellular mechanisms and their effects on the gene expression profiles. Therefore, in this study, we aimed at investigating the effects of glycerol and xylitol on human epidermal keratinocytes. The polyols (identical osmolarities; xylitol: 0.0045%-0.45%; glycerol: 0.0027%-0.27%) did not alter cellular viability or intracellular calcium concentration. However, they exerted differential effects on the expression of certain genes and signalling pathways. Indeed, both polyols up-regulated the expression of filaggrin, loricrin, involucrin and occludin; yet, xylitol exerted somewhat more profound effects. Moreover, while both polyols stimulated the MAPK pathway, only xylitol induced the activation-dependent translocation of protein kinase Cδ, a key promoter of epidermal differentiation. Finally, in various keratinocyte inflammation models, both polyols (albeit with different efficacies) exerted anti-inflammatory effects. Taken together, these data strongly suggest that glycerol and xylitol differentially modulate expressions of multiple genes and activities of signalling pathways in epidermal keratinocytes. Thus, our findings invite clinical trials to explore the applicability and the impact of a combined glycerol-xylitol therapy in the management of various skin conditions.
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Affiliation(s)
- Edit Páyer
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Judit Szabó-Papp
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Lídia Ambrus
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Gábor Szöllősi
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Mónika Andrási
- Department of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Lajos Kemény
- MTA-SZTE Dermatological Research Group, Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - István Juhász
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Andrea Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamás Bíró
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Oláh
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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19
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Anjum A, Chung PY, Ng SF. PLGA/xylitol nanoparticles enhance antibiofilm activity via penetration into biofilm extracellular polymeric substances. RSC Adv 2019; 9:14198-14208. [PMID: 35519311 PMCID: PMC9064039 DOI: 10.1039/c9ra00125e] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/24/2019] [Indexed: 11/21/2022] Open
Abstract
Biofilms are gelatinous masses of microorganisms attached to wound surfaces.
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Affiliation(s)
- Anam Anjum
- Centre for Drug Delivery Research
- Faculty of Pharmacy
- University Kebangsaan Malaysia
- Kuala Lumpur
- Malaysia
| | - Pooi-Yin Chung
- Department of Microbiology
- International Medical University
- Kuala Lumpur
- Malaysia
| | - Shiow-Fern Ng
- Centre for Drug Delivery Research
- Faculty of Pharmacy
- University Kebangsaan Malaysia
- Kuala Lumpur
- Malaysia
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20
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Abstract
As described in previous work, the use of synthetic chemical ingredients in modern cosmetics is postulated to be a cause of damage to the skin microbiome. The discovery that biodiversity on the human skin is currently the only reliable indicator of skin health, meant that for the first time, a mechanism to test for healthy skin was possible. Using this mechanism and in collaboration with The Medical University of Graz, who carried out the independent study, this work aimed to help answer whether modern day synthetic cosmetics are a main cause of long-term damage to the skin microbiome. Thirty-two human participants tested three different face washes for their effect on the skin’s microbial diversity, along with skin pH, moisture and TEWL (trans-epidermal water loss), washing twice-a-day for four weeks. The upper volar forearm of the volunteers was swabbed at the beginning, two weeks in and at the end of the four weeks. 16S rRNA sequencing was used. One leading ‘natural’ brand full of synthetic ingredients, a leading synthetic brand and a 100% natural face wash were used. Results give the first indications of a link between synthetic ingredients in a cosmetics product and its effect on skin microbiome biodiversity. It paves the way for future studies on the topic with a larger sample group, longer test period and standardised methodology to create a universal standard for testing the health of skin using benchmark diversity values. This can be used in the future to test the effectiveness of cosmetics or ingredients on skin health, leading to the restriction in cosmetics of products proven to harm the skin’s natural environment.
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21
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Hurlow JJ, Humphreys GJ, Bowling FL, McBain AJ. Diabetic foot infection: A critical complication. Int Wound J 2018; 15:814-821. [PMID: 29808598 PMCID: PMC7949853 DOI: 10.1111/iwj.12932] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/24/2018] [Accepted: 04/10/2018] [Indexed: 02/05/2023] Open
Abstract
The number of people in the world with diabetes has nearly quadrupled in the past 40 years. Current data show that 25% of these diabetics will develop a foot ulcer in their lifetime and that the cost of care for a diabetic foot ulcer (DFU) is over twice that of any other chronic ulcer aetiology. Microbial biofilm has been linked to both wound chronicity and infection. Close to 1 in 2 diabetics with a DFU are predicted to go on to develop a diabetic foot infection (DFI). The majority of these DFIs have been found to evolve even before the diabetic individual has received an initial referral for expert DFU management. Of these infected DFUs, less than half have been shown to heal over the next year; many of these individuals will require costly hospitalisation, and current data show that far too many DFIs will require extremity amputation to achieve infection resolution. The development of an infection in a DFU is critical at least in part because paradigms of infection prevention and management are evolving. The effectiveness of our current practice standards is being challenged by a growing body of research related to the prevalence and recalcitrance of the microbes in biofilm to topical and systemic antimicrobials. This article will review the magnitude of current challenges related to DFI prevention and management along with what is currently considered to be standard of care. These ideas will be compared and contrasted with what is known about the biofilm phenotype; then, considerations to support progress towards the development of more cost-effective protocols of care are highlighted.
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Affiliation(s)
- Jennifer J Hurlow
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Gavin J Humphreys
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Frank L Bowling
- Faculty of Medical & Human SciencesUniversity of ManchesterManchesterUK
- Manchester Foundation TrustDepartment of Diabetes & Vascular SurgeryManchesterUK
| | - Andrew J McBain
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
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22
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Anjum A, Sim CH, Ng SF. Hydrogels Containing Antibiofilm and Antimicrobial Agents Beneficial for Biofilm-Associated Wound Infection: Formulation Characterizations and In vitro Study. AAPS PharmSciTech 2018; 19:1219-1230. [PMID: 29280044 DOI: 10.1208/s12249-017-0937-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/05/2017] [Indexed: 11/30/2022] Open
Abstract
Bacterial biofilm which adheres onto wound surface is shown to be impervious to antibiotics and this in turn delays wound healing. Previous studies showed that antibiofilm agents such as xylitol and ethylenediaminetetraacetic acid (EDTA) prevent bacterial adherence onto surfaces. Formulation of a wound dressing containing antibiofilm agents may be a plausible strategy in breaking the biofilm on wound surfaces and at the same time increase the efficacy of the antibiotic. The purpose of this study was to develop hydrogel formulations containing antibiofilm agents along with antibiotic (gentamicin) for bacterial biofilm-associated wound infection. Sodium carboxymethyl cellulose (NaCMC) hydrogels loaded with antibiofilm agents and antibiotic were prepared. The hydrogels were characterized for their physical properties, rheology, Fourier transform infrared spectroscopy (FTIR), drug content uniformity, differential scanning calorimetry (DSC) and in vitro drug release study. The antibiofilm (Crystal Violet staining and XTT assay) and antibacterial performances of the hydrogels against Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, and Escherichia coli were assessed in vitro. The formulated hydrogels showed adequate release of both antibiofilm agents (xylitol and EDTA). Both antimicrobial and antibiofilm tests showed promising results and demonstrated that the combination of xylitol, EDTA, and gentamicin had an additive effect against both Gram-positive and Gram-negative bacteria. In summary, NaCMC (sodium carboxymethyl cellulose) hydrogels containing the combination of antimicrobial and antibiofilm agents were successfully developed and this can be a new strategy in combating biofilm in wound infection which in turn accelerate wound healing.
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23
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Kravvas G, Veitch D, Al-Niaimi F. The increasing relevance of biofilms in common dermatological conditions. J DERMATOL TREAT 2017; 29:202-207. [DOI: 10.1080/09546634.2017.1360989] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- G. Kravvas
- Department of Dermatology, University College London Hospital, London, UK
| | - D. Veitch
- Department of Dermatology, University College London Hospital, London, UK
| | - F. Al-Niaimi
- Department of Dermatologic Surgery and Laser Unit, St. Thomas' Hospital, St. John's Institute of Dermatology, London, UK
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24
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Camacho M, Oliva M, Serbus LR. Dietary saccharides and sweet tastants have differential effects on colonization of Drosophila oocytes by Wolbachia endosymbionts. Biol Open 2017; 6:1074-1083. [PMID: 28596296 PMCID: PMC5550908 DOI: 10.1242/bio.023895] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Wolbachia bacteria are widespread, maternally transmitted endosymbionts of insects. Maintenance of sufficient Wolbachia titer in maternal germline cells is required for transmission efficacy. The mechanisms that regulate Wolbachia titer are not well understood; however, dietary sucrose was reported to elevate oocyte Wolbachia titer in Drosophila melanogaster whereas dietary yeast decreased oocyte titer. To further investigate how oocyte Wolbachia titer is controlled, this study analyzed the response of wMel Wolbachia to diets enriched in an array of natural sugars and other sweet tastants. Confocal imaging of D. melanogaster oocytes showed that food enriched in dietary galactose, lactose, maltose and trehalose elevated Wolbachia titer. However, oocyte Wolbachia titers were unaffected by exposure to the sweet tastants lactulose, erythritol, xylitol, aspartame and saccharin as compared to the control. Oocyte size was generally non-responsive to the nutrient-altered diets. Ovary size, however, was consistently smaller in response to all sugar- and sweetener-enriched diets. Furthermore, most dietary sugars administered in tandem with dietary yeast conferred complete rescue of oocyte titer suppression by yeast. All diets dually enriched in yeast and sugar also rescued yeast-associated ovary volume changes. This indicates oocyte colonization by Wolbachia to be a nutritionally sensitive process regulated by multiple mechanistic inputs.
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Affiliation(s)
- Moises Camacho
- Department of Biological Sciences, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA.,Biomolecular Sciences Institute, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA
| | - Mailin Oliva
- Department of Biological Sciences, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA.,Biomolecular Sciences Institute, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA
| | - Laura R Serbus
- Department of Biological Sciences, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA .,Biomolecular Sciences Institute, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA
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25
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Lin L, Tang X, Wei J, Dai F, Sun G. Xylitol nasal irrigation in the treatment of chronic rhinosinusitis. Am J Otolaryngol 2017; 38:383-389. [PMID: 28390807 DOI: 10.1016/j.amjoto.2017.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/02/2017] [Accepted: 03/31/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the efficacy of xylitol nasal irrigation (XNI) treatment on chronic rhinosinusitis (CRS) and to investigate the effect of XNI on nasal nitric oxide (NO) and inducible nitric oxide synthase (iNOS) mRNA in maxillary sinus. MATERIALS AND METHODS Patients with CRS were enrolled and symptoms were assessed by Visual Analog Scale (VAS) and Sino-Nasal Outcome Test 22 (SNOT-22). Nasal NO and iNOS mRNA in the right maxillary sinus were also examined. Then, they were treated with XNI (XNI group) or saline nasal irrigation (SNI, SNI group) for 30days, after which their symptoms were reassessed using VAS and SNOT-22, and nasal NO and iNOS mRNA in the right maxillary sinus were also reexamined. RESULTS Twenty-five out of 30 patients completed this study. The scores of VAS and SNOT-22 were all reduced significantly after XNI treatment, but not after SNI. The concentrations of nasal NO and iNOS mRNA in the right maxillary sinus were increased significantly in XNI group. However, significant changes were not found after SNI treatment. Furthermore, there were statistical differences in the assessments of VAS and SNOT-22 and the contents of nasal NO and iNOS mRNA in the right maxillary sinus between two groups. CONCLUSIONS XNI results in greater improvement of symptoms of CRS and greater enhancement of nasal NO and iNOS mRNA in maxillary sinus as compared to SNI.
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Affiliation(s)
- Lin Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai, China.
| | - Xinyue Tang
- Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Jinjin Wei
- Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Fei Dai
- Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Guangbin Sun
- Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai, China
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26
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Meta Analysis of Skin Microbiome: New Link between Skin Microbiota Diversity and Skin Health with Proposal to Use This as a Future Mechanism to Determine Whether Cosmetic Products Damage the Skin. COSMETICS 2017. [DOI: 10.3390/cosmetics4020014] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Barbieri R, Coppo E, Marchese A, Daglia M, Sobarzo-Sánchez E, Nabavi SF, Nabavi SM. Phytochemicals for human disease: An update on plant-derived compounds antibacterial activity. Microbiol Res 2016; 196:44-68. [PMID: 28164790 DOI: 10.1016/j.micres.2016.12.003] [Citation(s) in RCA: 292] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 12/11/2022]
Abstract
In recent years, many studies have shown that phytochemicals exert their antibacterial activity through different mechanisms of action, such as damage to the bacterial membrane and suppression of virulence factors, including inhibition of the activity of enzymes and toxins, and bacterial biofilm formation. In this review, we summarise data from the available literature regarding the antibacterial effects of the main phytochemicals belonging to different chemical classes, alkaloids, sulfur-containing phytochemicals, terpenoids, and polyphenols. Some phytochemicals, besides having direct antimicrobial activity, showed an in vitro synergistic effect when tested in combination with conventional antibiotics, modifying antibiotic resistance. Review of the literature showed that phytochemicals represent a possible source of effective, cheap and safe antimicrobial agents, though much work must still be carried out, especially in in vivo conditions to ensure the selection of effective antimicrobial substances with low side and adverse effects.
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Affiliation(s)
| | - Erika Coppo
- Sezione di Microbiologia DISC University of Genoa, Italy
| | - Anna Marchese
- Sezione di Microbiologia DISC-IRCCS San Martino-IST University of Genoa, Italy.
| | - Maria Daglia
- Department of Drug Sciences, Medicinal Chemistry and Pharmaceutical Technology Section, University of Pavia, Italy
| | - Eduardo Sobarzo-Sánchez
- Laboratory of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Santiago de Compostela, 15782, Spain; Dirección de Investigación, Universidad Central de Chile, Santiago, Chile
| | - Seyed Fazel Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Brandwein M, Steinberg D, Meshner S. Microbial biofilms and the human skin microbiome. NPJ Biofilms Microbiomes 2016; 2:3. [PMID: 28649397 PMCID: PMC5460139 DOI: 10.1038/s41522-016-0004-z] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 07/22/2016] [Accepted: 08/08/2016] [Indexed: 12/14/2022] Open
Abstract
The human skin microbiome plays an important role in both health and disease. Microbial biofilms are a well-characterized mode of surface-associated growth, which present community-like behaviors. Additionally, biofilms are a critical element in certain skin diseases. We review how the perception of the resident skin microbiota has evolved from the early linkages of certain microbes to disease states, to a more comprehensive and intricate understanding brought on by biofilm and microbiome revelations. Rapidly expanding arsenals of experimental methods are opening new horizons in the study of human-microbe and microbe-microbe interactions. Microbial community profiling has largely remained a separate discipline from that of biofilm research, yet the introduction of metatranscriptomics, metabolomics, and the ability to distinguish between dormant and active members of a community have all paved the road toward a convergent cognizance of the encounter between these two microbial disciplines.
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Affiliation(s)
- Michael Brandwein
- Faculty of Dental Medicine, The Hebrew University of Jerusalem, Hadassah Ein Kerem, Jerusalem, Israel
- Dead Sea and Arava Science Center, The Dead Sea Microbiology lab, Ein Gedi, Israel
| | - Doron Steinberg
- Faculty of Dental Medicine, The Hebrew University of Jerusalem, Hadassah Ein Kerem, Jerusalem, Israel
| | - Shiri Meshner
- Dead Sea and Arava Science Center, The Dead Sea Microbiology lab, Ein Gedi, Israel
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Trivedi U, Madsen JS, Rumbaugh KP, Wolcott RD, Burmølle M, Sørensen SJ. A post-planktonic era of in vitro infectious models: issues and changes addressed by a clinically relevant wound like media. Crit Rev Microbiol 2016; 43:453-465. [PMID: 27869519 DOI: 10.1080/1040841x.2016.1252312] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Medical science is pitted against an ever-increasing rise in antibiotic tolerant microorganisms. Concurrently, during the past decade, biofilms have garnered much attention within research and clinical practice. Although the significance of clinical biofilms is becoming very apparent, current methods for diagnostics and direction of therapy plans in many hospitals do not reflect this knowledge; with many of the present tools proving to be inadequate for accurately mimicking the biofilm phenomenon. Based on current findings, we address some of the fundamental issues overlooked by clinical labs: the paradigm shifts that need to occur in assessing chronic wounds; better simulation of physiological conditions in vitro; and the importance of incorporating polymicrobial populations into biofilm models. In addition, this review considers using a biofilm relevant in vitro model for cultivating and determining the antibiotic tolerance and susceptibility of microorganisms associated with chronic wounds. This model presents itself as a highly rapid and functional tool that can be utilized by hospitals in an aim to improve bedside treatments.
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Affiliation(s)
- Urvish Trivedi
- a Department of Biology, Faculty of Science , Section of Microbiology, University of Copenhagen , Copenhagen , Denmark
| | - Jonas S Madsen
- a Department of Biology, Faculty of Science , Section of Microbiology, University of Copenhagen , Copenhagen , Denmark
| | - Kendra P Rumbaugh
- b Department of Surgery , Texas Tech University Health Sciences Center , Lubbock , TX , USA
| | | | - Mette Burmølle
- a Department of Biology, Faculty of Science , Section of Microbiology, University of Copenhagen , Copenhagen , Denmark
| | - Søren J Sørensen
- a Department of Biology, Faculty of Science , Section of Microbiology, University of Copenhagen , Copenhagen , Denmark
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Varshney R, Lee JT. Current trends in topical therapies for chronic rhinosinusitis: update and literature review. Expert Opin Drug Deliv 2016; 14:257-271. [PMID: 27500891 DOI: 10.1080/17425247.2016.1214563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Chronic rhinosinusitis (CRS) affects millions of patients worldwide. The disease is multifactorial with influences including anatomic factors, immunological disturbances, and altered sinonasal microbiome. Although oral medications are effective in controlling some symptoms, they are associated with side effects and long-term use is not ideal. Thus, topical therapies have emerged as an alternative delivery method for localized, high-concentration medication with less side effects. Areas covered: This is a review of the various topical therapies available or under investigation for the management of CRS. Common medications such as saline, steroids, and antimicrobials will be discussed. Furthermore, additives including manuka honey, xylitol, surfactant, N-chlorotaurine, Dead Sea salt, and sodium hyaluronate will be addressed. Innovations in topical therapies, such as drug-eluting biomaterials and photodynamic therapy, will also be reviewed. Expert opinion: Although topical therapies provide a high dose of active substance at the site of disease, their efficacy in CRS is not clear. Topical saline and intranasal steroids appear to consistently demonstrate therapeutic benefits. However, other topical medications require further investigation to determine long-term clinical efficacy and safety. A better understanding of their effects on the sinonasal mucociliary system is needed before they become the standard of care in CRS.
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Affiliation(s)
- Rickul Varshney
- a Orange County Sinus Institute , Southern California Permanente Medical Group , Irvine , CA , USA
| | - Jivianne T Lee
- a Orange County Sinus Institute , Southern California Permanente Medical Group , Irvine , CA , USA.,b Department of Head & Neck Surgery , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
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Gupta AK, Daigle D, Carviel JL. The role of biofilms in onychomycosis. J Am Acad Dermatol 2016; 74:1241-6. [DOI: 10.1016/j.jaad.2016.01.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/05/2016] [Accepted: 01/06/2016] [Indexed: 10/22/2022]
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Tissue Plasminogen Activator Coating on Implant Surfaces Reduces Staphylococcus aureus Biofilm Formation. Appl Environ Microbiol 2015; 82:394-401. [PMID: 26519394 DOI: 10.1128/aem.02803-15] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/21/2015] [Indexed: 12/15/2022] Open
Abstract
Staphylococcus aureus biofilm infections of indwelling medical devices are a major medical challenge because of their high prevalence and antibiotic resistance. As fibrin plays an important role in S. aureus biofilm formation, we hypothesize that coating of the implant surface with fibrinolytic agents can be used as a new method of antibiofilm prophylaxis. The effect of tissue plasminogen activator (tPA) coating on S. aureus biofilm formation was tested with in vitro microplate biofilm assays and an in vivo mouse model of biofilm infection. tPA coating efficiently inhibited biofilm formation by various S. aureus strains. The effect was dependent on plasminogen activation by tPA, leading to subsequent local fibrin cleavage. A tPA coating on implant surfaces prevented both early adhesion and later biomass accumulation. Furthermore, tPA coating increased the susceptibility of biofilm infections to antibiotics. In vivo, significantly fewer bacteria were detected on the surfaces of implants coated with tPA than on control implants from mice treated with cloxacillin. Fibrinolytic coatings (e.g., with tPA) reduce S. aureus biofilm formation both in vitro and in vivo, suggesting a novel way to prevent bacterial biofilm infections of indwelling medical devices.
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Kwiecinski J, Peetermans M, Liesenborghs L, Na M, Björnsdottir H, Zhu X, Jacobsson G, Johansson BR, Geoghegan JA, Foster TJ, Josefsson E, Bylund J, Verhamme P, Jin T. Staphylokinase Control of Staphylococcus aureus Biofilm Formation and Detachment Through Host Plasminogen Activation. J Infect Dis 2015; 213:139-48. [PMID: 26136471 DOI: 10.1093/infdis/jiv360] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 06/22/2015] [Indexed: 02/07/2023] Open
Abstract
Staphylococcus aureus biofilms, a leading cause of persistent infections, are highly resistant to immune defenses and antimicrobial therapies. In the present study, we investigated the contribution of fibrin and staphylokinase (Sak) to biofilm formation. In both clinical S. aureus isolates and laboratory strains, high Sak-producing strains formed less biofilm than strains that lacked Sak, suggesting that Sak prevents biofilm formation. In addition, Sak induced detachment of mature biofilms. This effect depended on plasminogen activation by Sak. Host-derived fibrin, the main substrate cleaved by Sak-activated plasminogen, was a major component of biofilm matrix, and dissolution of this fibrin scaffold greatly increased susceptibility of biofilms to antibiotics and neutrophil phagocytosis. Sak also attenuated biofilm-associated catheter infections in mouse models. In conclusion, our results reveal a novel role for Sak-induced plasminogen activation that prevents S. aureus biofilm formation and induces detachment of existing biofilms through proteolytic cleavage of biofilm matrix components.
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Affiliation(s)
- Jakub Kwiecinski
- Department of Rheumatology and Inflammation Research, Institute of Medicine
| | - Marijke Peetermans
- Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Laurens Liesenborghs
- Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Manli Na
- Department of Rheumatology and Inflammation Research, Institute of Medicine
| | - Halla Björnsdottir
- Department of Rheumatology and Inflammation Research, Institute of Medicine
| | - Xuefeng Zhu
- Department of Medical Biochemistry and Cell Biology
| | - Gunnar Jacobsson
- Department of Infectious Diseases, Skaraborg Hospital, Skövde, Sweden
| | | | - Joan A Geoghegan
- Department of Microbiology, Moyne Institute of Preventive Medicine, School of Genetics and Microbiology, Trinity College, Dublin, Ireland
| | - Timothy J Foster
- Department of Microbiology, Moyne Institute of Preventive Medicine, School of Genetics and Microbiology, Trinity College, Dublin, Ireland
| | - Elisabet Josefsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine
| | - Johan Bylund
- Department of Rheumatology and Inflammation Research, Institute of Medicine Department of Oral Microbiology and Immunology, Sahlgrenska Academy at University of Gothenburg
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Tao Jin
- Department of Rheumatology and Inflammation Research, Institute of Medicine
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Ng SF, Leow HL. Development of biofilm-targeted antimicrobial wound dressing for the treatment of chronic wound infections. Drug Dev Ind Pharm 2015; 41:1902-9. [DOI: 10.3109/03639045.2015.1019888] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Biofilm formation by Staphylococcus aureus isolates from skin and soft tissue infections. Curr Microbiol 2015; 70:698-703. [PMID: 25586078 DOI: 10.1007/s00284-014-0770-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 11/25/2014] [Indexed: 10/24/2022]
Abstract
Many diseases caused by Staphylococcus aureus are associated with biofilm formation. However, the ability of S. aureus isolates from skin and soft tissue infections to form biofilms has not yet been investigated. We tested 160 isolates from patients with various skin infections for biofilm-forming capacity in different growth media. All the isolates formed biofilms, the extent of which depended on the type of growth medium. The thickest biofilms were formed when both plasma and glucose were present in the broth; in this case, S. aureus incorporated host fibrin into the biofilm's matrix. There were no differences in the biofilm formation between isolates from different types of skin infections, except for a particularly good biofilm formation by isolates from diabetic wounds and a weaker biofilm formation by isolates from impetigo. In conclusion, biofilm formation is a universal behavior of S. aureus isolates from skin infections. In some cases, such as in diabetic wounds, a particularly strong biofilm formation most likely contributes to the chronic and recurrent character of the infection. Additionally, as S. aureus apparently uses host fibrin as part of the biofilm structure, we suggest that plasma should be included more frequently in in vitro biofilm studies.
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Slane JA, Vivanco JF, Rose WE, Squire MW, Ploeg HL. The influence of low concentrations of a water soluble poragen on the material properties, antibiotic release, and biofilm inhibition of an acrylic bone cement. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 42:168-76. [PMID: 25063107 DOI: 10.1016/j.msec.2014.05.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/26/2014] [Accepted: 05/06/2014] [Indexed: 12/21/2022]
Abstract
Soluble particulate fillers can be incorporated into antibiotic-loaded acrylic bone cement in an effort to enhance antibiotic elution. Xylitol is a material that shows potential for use as a filler due to its high solubility and potential to inhibit biofilm formation. The objective of this work, therefore, was to investigate the usage of low concentrations of xylitol in a gentamicin-loaded cement. Five different cements were prepared with various xylitol loadings (0, 1, 2.5, 5 or 10 g) per cement unit, and the resulting impact on the mechanical properties, cumulative antibiotic release, biofilm inhibition, and thermal characteristics were quantified. Xylitol significantly increased cement porosity and a sustained increase in gentamicin elution was observed in all samples containing xylitol with a maximum cumulative release of 41.3%. Xylitol had no significant inhibitory effect on biofilm formation. All measured mechanical properties tended to decrease with increasing xylitol concentration; however, these effects were not always significant. Polymerization characteristics were consistent among all groups with no significant differences found. The results from this study indicate that xylitol-modified bone cement may not be appropriate for implant fixation but could be used in instances where sustained, increased antibiotic elution is warranted, such as in cement spacers or beads.
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Affiliation(s)
- Josh A Slane
- Materials Science Program, University of Wisconsin-Madison, Madison, WI, USA; Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA.
| | - Juan F Vivanco
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA; Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibañez, Viña del Mar, Chile
| | - Warren E Rose
- Pharmacy Practice Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Matthew W Squire
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Heidi-Lynn Ploeg
- Materials Science Program, University of Wisconsin-Madison, Madison, WI, USA; Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA
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Söderling E, ElSalhy M, Honkala E, Fontana M, Flannagan S, Eckert G, Kokaras A, Paster B, Tolvanen M, Honkala S. Effects of short-term xylitol gum chewing on the oral microbiome. Clin Oral Investig 2014; 19:237-44. [PMID: 24663814 DOI: 10.1007/s00784-014-1229-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/17/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to determine the effects of short-term xylitol gum chewing on the salivary microbiota of children. MATERIALS AND METHODS The study was a randomised, controlled, double-blind trial. Healthy children used xylitol chewing gum (xylitol group, n = 35) or sorbitol chewing gum (control group, n = 38) for 5 weeks. The daily dose of xylitol/sorbitol was approximately 6 g/day. At baseline and at the end of the test period, unstimulated and paraffin-stimulated saliva were collected. The microbial composition of the saliva was assessed using human oral microbe identification microarray (HOMIM). Mutans streptococci (MS) were plate cultured. RESULTS As judged by HOMIM results, no xylitol-induced changes in the salivary microbiota took place in the xylitol group. In the control group, Veillonella atypica showed a significant decrease (p = 0.0001). The xylitol gum chewing decreased viable counts of MS in both stimulated (p = 0.006) and unstimulated (p = 0.002) saliva, but similar effects were also seen in the control group. CONCLUSIONS The use of xylitol gum decreased MS, in general, but did not change the salivary microbial composition. CLINICAL RELEVANCE Short-term consumption of xylitol had no impact on the composition of the salivary microbiota, but resulted in a decrease in the levels of MS.
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Affiliation(s)
- Eva Söderling
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland,
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Park JS, Kwon JK, Kim HR, Kim HJ, Kim BS, Jung JY. Farnesol induces apoptosis of DU145 prostate cancer cells through the PI3K/Akt and MAPK pathways. Int J Mol Med 2014; 33:1169-76. [PMID: 24584843 DOI: 10.3892/ijmm.2014.1679] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 02/13/2014] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to investigate the effect of farnesol on the induction of apoptosis in DU145 prostate cancer cells. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay showed that cell proliferation decreased significantly in a dose- and time-dependent manner. 4',6-Diamidino-2-phenylindole staining showed that chromatin condensation in cells treated with 60 µM of farnesol was markedly higher than in the control groups. Farnesol increased the expression of p53, p-c-Jun N-terminal kinase, cleaved-caspase-3, Bax, and cleaved-caspase-9, but decreased the expression of p-phosphatidylinositol-3-kinase (PI3K), p-Akt, p-p38, Bcl-2, and p-extracellular signal-regulated protein kinase, in a dose-dependent manner. The apoptotic cell ratio increased in a dose-dependent manner. The tumor growth inhibitory effect of farnesol was investigated in a mouse model. Compared to the control group, tumor volume decreased significantly in the group administered 50 mg/kg farnesol. Apoptosis was frequently detected in this same group by terminal deoxynucleotidyl transferase dUTP nick-end labeling assay. The results indicated that farnesol induced apoptosis of DU145 prostate cancer cells through the PI3K/Akt and mitogen-activated protein kinase signaling pathways.
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Affiliation(s)
- Jin Soo Park
- Department of Companion and Laboratory Animal Science, Kongju National University, Yesan, Chungnam 340702, Republic of Korea
| | - Jung Ki Kwon
- Department of Companion and Laboratory Animal Science, Kongju National University, Yesan, Chungnam 340702, Republic of Korea
| | - Hye Ri Kim
- Department of Companion and Laboratory Animal Science, Kongju National University, Yesan, Chungnam 340702, Republic of Korea
| | - Hyeong Jin Kim
- Department of Companion and Laboratory Animal Science, Kongju National University, Yesan, Chungnam 340702, Republic of Korea
| | - Byeong Soo Kim
- Department of Companion and Laboratory Animal Science, Kongju National University, Yesan, Chungnam 340702, Republic of Korea
| | - Ji Youn Jung
- Department of Companion and Laboratory Animal Science, Kongju National University, Yesan, Chungnam 340702, Republic of Korea
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Hashino E, Kuboniwa M, Alghamdi SA, Yamaguchi M, Yamamoto R, Cho H, Amano A. Erythritol alters microstructure and metabolomic profiles of biofilm composed of Streptococcus gordonii and Porphyromonas gingivalis. Mol Oral Microbiol 2013; 28:435-51. [PMID: 23890177 DOI: 10.1111/omi.12037] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2013] [Indexed: 11/26/2022]
Abstract
The effects of sugar alcohols such as erythritol, xylitol, and sorbitol on periodontopathic biofilm are poorly understood, though they have often been reported to be non-cariogenic sweeteners. In the present study, we evaluated the efficacy of sugar alcohols for inhibiting periodontopathic biofilm formation using a heterotypic biofilm model composed of an oral inhabitant Streptococcus gordonii and a periodontal pathogen Porphyromonas gingivalis. Confocal microscopic observations showed that the most effective reagent to reduce P. gingivalis accumulation onto an S. gordonii substratum was erythritol, as compared with xylitol and sorbitol. In addition, erythritol moderately suppressed S. gordonii monotypic biofilm formation. To examine the inhibitory effects of erythritol, we analyzed the metabolomic profiles of erythritol-treated P. gingivalis and S. gordonii cells. Metabolome analyses using capillary electrophoresis time-of-flight mass spectrometry revealed that a number of nucleic intermediates and constituents of the extracellular matrix, such as nucleotide sugars, were decreased by erythritol in a dose-dependent manner. Next, comparative analyses of metabolites of erythritol- and sorbitol-treated cells were performed using both organisms to determine the erythritol-specific effects. In P. gingivalis, all detected dipeptides, including Glu-Glu, Ser-Glu, Tyr-Glu, Ala-Ala and Thr-Asp, were significantly decreased by erythritol, whereas they tended to be increased by sorbitol. Meanwhile, sorbitol promoted trehalose 6-phosphate accumulation in S. gordonii cells. These results suggest that erythritol has inhibitory effects on dual species biofilm development via several pathways, including suppression of growth resulting from DNA and RNA depletion, attenuated extracellular matrix production, and alterations of dipeptide acquisition and amino acid metabolism.
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Affiliation(s)
- E Hashino
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Suita-Osaka, Japan
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Alves FRF, Neves MAS, Silva MG, Rocas IN, Siqueira Jr. JF. Antibiofilm and Antibacterial Activities of Farnesol and Xylitol as Potential Endodontic Irrigants. Braz Dent J 2013; 24:224-9. [DOI: 10.1590/0103-6440201302187] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 04/10/2013] [Indexed: 01/20/2023] Open
Abstract
This study investigated the antibiofilm and antibacterial effects of farnesol and xylitol in a series of experiments in order to evaluate their potential use as root canal irrigants. The following substances were tested: 0.2% farnesol; 5% and 20% xylitol; 0.2% farnesol plus 20% xylitol; and saline (control). For comparison with an established endodontic irrigant, 2.5% NaOCl was included in each test. Three experiments were conducted: the crystal violet assay, to evaluate the effects on the biofilm biomass; the dentin disinfection test, to evaluate the effects on bacterial viability in biofilms; and the root canal disinfection test, to simulate the use in the root canal environment. Farnesol was the most effective substance in reducing the biofilm biomass, followed by 20% xylitol. All substances affected bacterial viability in biofilms; farnesol showed the best results followed by the farnesol/xylitol combination. Irrigation with all substances significantly reduced the bacterial load (p<0.001), but only the farnesol/xylitol combination was significantly more effective than saline (p=0.02). NaOCl was more effective than any other substance tested in the three experiments (p<0.001). The findings demonstrated that farnesol affected both the biofilm biomass and the viability of cells in the biofilm, while 20% xylitol affected only the biofilm biomass. Although not more effective than NaOCl, the combination of these two antibiofilm substances has potential to be used in endodontics in certain situations.
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Vanassche T, Peetermans M, Van Aelst LNL, Peetermans WE, Verhaegen J, Missiakas DM, Schneewind O, Hoylaerts MF, Verhamme P. The role of staphylothrombin-mediated fibrin deposition in catheter-related Staphylococcus aureus infections. J Infect Dis 2013; 208:92-100. [PMID: 23532100 DOI: 10.1093/infdis/jit130] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Staphylococcus aureus (S. aureus) is a frequent cause of catheter-related infections. S. aureus secretes the coagulases staphylocoagulase and von Willebrand factor-binding protein, both of which form a staphylothrombin complex upon binding to prothrombin. Although fibrinogen and fibrin facilitate the adhesion of S. aureus to catheters, the contribution of staphylothrombin-mediated fibrin has not been examined. In this study, we use a S. aureus mutant lacking both coagulases (Δcoa/vwb) and dabigatran, a pharmacological inhibitor of both staphylothrombin and thrombin, to address this question. Genetic absence or chemical inhibition of pathogen-driven coagulation reduced both fibrin deposition and the retention of S. aureus on catheters in vitro. In a mouse model of jugular vein catheter infection, dabigatran reduced bacterial load on jugular vein catheters, as well as metastatic kidney infection. Importantly, inhibition of staphylothrombin improved the efficacy of vancomycin treatment both in vitro and in the mouse model.
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Affiliation(s)
- Thomas Vanassche
- Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, University of Leuven, Herestraat 49, B-3000 Leuven, Belgium.
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Li C, Zhang X, Huang X, Wang X, Liao G, Chen Z. Preparation and characterization of flexible nanoliposomes loaded with daptomycin, a novel antibiotic, for topical skin therapy. Int J Nanomedicine 2013; 8:1285-92. [PMID: 23569376 PMCID: PMC3615926 DOI: 10.2147/ijn.s41695] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to investigate flexible nanoliposomes for mediating topical delivery of daptomycin, and to document permeation rates and bacteriostatic activity towards skin infections. Response surface methodology was used to optimize the daptomycin-loaded flexible nanoliposomes (DAP-FL), and the amount of drug loaded into the particles was evaluated as the investigation index. The optimal lipid ratio was lecithin to sodium cholate 17:1 (w/w) and the lipid to drug ratio was 14:1 (w/w). The hydration temperature was set at 37°C and the duration of treatment with ultrasound was 20 minutes. The DAP-FL obtained had a small mean particle size (55.4 nm) with a narrow size distribution (polydispersity index 0.15). The mean entrapment efficiency was 87.85% ± 2.15% and the mean percent drug loading was 5.61% ± 0.14%. Using skin mounted between the donor and receptor compartments of a modified Franz diffusion cell, the percentage and quantity of cumulative daptomycin permeation from DAP-FL within 12 hours were measured at 96.28% ± 0.70% and (132.23 ± 17.73) μg/cm(2) *5 = 661.15 ± 88.65 μg/cm(2), directly, showing rapid and efficient antibacterial activity against Staphylococcus aureus. Following local administration of DAP-FL, daptomycin was detected in multilayer tissues within the skin and underlying structures in the dorsal skin of the mouse. Effective therapeutic concentrations were maintained for several hours, and significantly inhibited bacterial growth and injury-induced biofilms. These results demonstrate that the DAP-FL can enhance the ability of daptomycin to permeate the skin efficiently, where it has a powerful antibacterial action and activity against biofilms. This novel formulation of daptomycin has potential as a new approach in the clinical application of daptomycin.
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Affiliation(s)
- Chong Li
- College of Pharmaceutical Sciences, Southwest University, Chongqing, People's Republic of China
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Alves FRF, Silva MG, Rôças IN, Siqueira Jr JF. Biofilm biomass disruption by natural substances with potential for endodontic use. Braz Oral Res 2013; 27:20-5. [DOI: 10.1590/s1806-83242013000100004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 11/12/2012] [Indexed: 01/09/2023] Open
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Use of xylitol to enhance the therapeutic efficacy of polymethylmethacrylate-based antibiotic therapy in treatment of chronic osteomyelitis. Antimicrob Agents Chemother 2012; 56:5839-44. [PMID: 22948866 DOI: 10.1128/aac.01127-12] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Using a rabbit model of postsurgical osteomyelitis, we demonstrate that incorporation of xylitol into polymethylmethacrylate (PMMA) bone cement enhances the elution of daptomycin under in vivo conditions. We also demonstrate that this can be correlated with an improved therapeutic outcome in the treatment of a chronic bone infection following surgical debridement.
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Marttinen AM, Ruas-Madiedo P, Hidalgo-Cantabrana C, Saari MA, Ihalin RA, Söderling EM. Effects of Xylitol on Xylitol-Sensitive Versus Xylitol-Resistant Streptococcus mutans Strains in a Three-Species in Vitro Biofilm. Curr Microbiol 2012; 65:237-43. [DOI: 10.1007/s00284-012-0151-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 05/12/2012] [Indexed: 11/28/2022]
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Tavaria FK, Soares JC, Reis IL, Paulo MH, Malcata FX, Pintado ME. Chitosan: antimicrobial action upon staphylococci after impregnation onto cotton fabric. J Appl Microbiol 2012; 112:1034-41. [PMID: 22380634 DOI: 10.1111/j.1365-2672.2012.05274.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND High levels of viable Staphylococcus aureus, which are often found on inflamed skin surfaces, are usually associated with atopic dermatitis. Textiles, owing to their high specific surface area and intrinsic hydrophilicity, retain moisture while also providing excellent environmental conditions for microbial growth and proliferation. Recently, a number of chemicals have been added to textiles, so as to confer antimicrobial activity. AIMS To evaluate the antimicrobial action of chitosan upon selected skin staphylococci. METHODS AND RESULTS We isolated staphylococci from normal skin of 24 volunteers and studied their survival upon contact with chitosan-impregnated cotton fabric. Low and high molecular weight chitosans were used at two concentrations; all four did effectively reduce the growth of some staphylococci (namely Staph. aureus), by up to 5 log cycles, thus unfolding a potential towards control and even prevention of related skin disorders. CONCLUSION Our data suggest an effective, but selective antibacterial action of chitosans towards skin bacteria. SIGNIFICANCE AND IMPACT OF THE STUDY The possibility to use a natural biopolymer incorporated in a textile to alleviate and even treat some of the symptoms associated with this skin condition may raise an alternative to existing medical treatments. The selectivity observed prevents full elimination of bacteria from the skin surface, which is an advantage.
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Affiliation(s)
- F K Tavaria
- Centro de Biologia e Química Fina (CBQF), Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Porto, Portugal
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Weissman JD, Fernandez F, Hwang PH. Xylitol nasal irrigation in the management of chronic rhinosinusitis: a pilot study. Laryngoscope 2011; 121:2468-72. [PMID: 21994147 DOI: 10.1002/lary.22176] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 05/01/2011] [Accepted: 05/04/2011] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the tolerability of xylitol mixed with water as a nasal irrigant and to evaluate whether xylitol nasal irrigation results in symptomatic improvement of subjects with chronic rhinosinusitis. STUDY DESIGN A prospective, randomized, double-blinded, controlled crossover pilot study. METHODS Twenty subjects were instructed to perform sequential 10-day courses of daily xylitol and saline irrigations in a randomized fashion, with a 3-day washout irrigation rest period at the start of each treatment arm. Collected data included patient characteristics, along with Sino-Nasal Outcome Test 20 (SNOT-20) and Visual Analog Scale (VAS) scores reported at the beginning and end of each irrigation course. RESULTS Fifteen of the 20 subjects (75%) returned their SNOT-20 and VAS data for analysis. There was a significant reduction in SNOT-20 score during the xylitol phase of irrigation (mean drop of 2.43 points) as compared to the saline phase (mean increase of 3.93 points), indicating improved sinonasal symptoms (P = .0437). There was no difference in VAS scores. No patient stopped performing the irrigations owing to intolerance of the xylitol, although its sweet taste was not preferred by three subjects (21%). One patient reported transient stinging with xylitol. CONCLUSIONS Xylitol in water is a well-tolerated agent for sinonasal irrigation. In the short term, xylitol irrigations result in greater improvement of symptoms of chronic rhinosinusitis as compared to saline irrigation.
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Affiliation(s)
- Joshua D Weissman
- Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, California, USA
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Vlassova N, Han A, Zenilman J, James G, Lazarus G. New horizons for cutaneous microbiology: the role of biofilms in dermatological disease. Br J Dermatol 2011; 165:751-9. [DOI: 10.1111/j.1365-2133.2011.10458.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- N. Vlassova
- Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205, U.S.A
| | - A. Han
- Department of Dermatology, Johns Hopkins Medical Institutions, 2500 Mason F. Lord, 4940 Eastern Avenue, Baltimore, MD 21224‐2780, U.S.A
| | - J.M. Zenilman
- Department of Medicine, Infectious Diseases Division, Johns Hopkins Medical Institutions, Baltimore, MD, U.S.A
| | - G. James
- Center for Biofilm Engineering, Montana State University, Bozeman, MT, U.S.A
| | - G.S. Lazarus
- Department of Dermatology, Johns Hopkins Medical Institutions, 2500 Mason F. Lord, 4940 Eastern Avenue, Baltimore, MD 21224‐2780, U.S.A
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Shin K, Lee TR, Lee E, Jeong YH, Yun Y, Park TH, Kim H, Ghafoor K, Park J. Staphylococcus aureus in relation to physical, physiological and subjective conditions of apparently normal human skin. J Dermatol Sci 2011; 63:201-3. [DOI: 10.1016/j.jdermsci.2011.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 04/15/2011] [Accepted: 05/08/2011] [Indexed: 11/16/2022]
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