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Mai Y, Wang Z, Zhou Y, Wang G, Chen J, Lin Y, Ji P, Zhang W, Jing Q, Chen L, Chen Z, Lin H, Jiang L, Yuan C, Xu P, Huang M. From disinfectants to antibiotics: Enhanced biosafety of quaternary ammonium compounds by chemical modification. JOURNAL OF HAZARDOUS MATERIALS 2023; 460:132454. [PMID: 37703742 DOI: 10.1016/j.jhazmat.2023.132454] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
The excessive use of quaternary ammonium compounds (QACs) following the COVID-19 pandemic has raised substantial concerns regarding their biosafety. Overuse of QACs has been associated with chronic biological adverse effects, including genotoxicity or carcinogenicity. In particular, inadvertent intravascular administration or oral ingestion of QACs can lead to fatal acute toxicity. To enhance the biosafety and antimicrobial efficacy of QACs, this study reports a new series of QACs, termed as PACs, with the alkyl chain of benzalkonium substituted by a phthalocyanine moiety. Firstly, the rigid phthalocyanine moiety enhances the selectivity of QACs to bacteria over human cells and reduces alkyl chain's entropic penalty of binding to bacterial membranes. Furthermore, phthalocyanine neutralizes hemolysis and cytotoxicity of QACs by binding with albumin in plasma. Our experimental results demonstrate that PACs inherit the optical properties of phthalocyanine and validate the broad-spectrum antibacterial activity of PACs in vitro. Moreover, the intravascular administration of the most potent PAC, PAC1a, significantly reduced bacterial burden and ameliorated inflammation level in a bacteria-induced septic mouse model. This study presents a new strategy to improve the antimicrobial efficacy and biosafety of QACs, thus expanding their range of applications to the treatment of systemic infections.
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Affiliation(s)
- Yuhan Mai
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Zhiyou Wang
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Yang Zhou
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Guodong Wang
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Jingyi Chen
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Yuxin Lin
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Panpan Ji
- College of Biological Science and Engineering, Fuzhou University, Fuzhou, Fujian 350108, PR China
| | - Wei Zhang
- College of Biological Science and Engineering, Fuzhou University, Fuzhou, Fujian 350108, PR China
| | - Qian Jing
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Liyun Chen
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Zheng Chen
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Haili Lin
- Department of Pharmacy, The Peoples Hospital of Fujian Province, Fuzhou, Fujian 350004, PR China
| | - Longguang Jiang
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China
| | - Cai Yuan
- College of Biological Science and Engineering, Fuzhou University, Fuzhou, Fujian 350108, PR China; Fujian Key Laboratory of Marine Enzyme Engineering, Fuzhou University, Fuzhou, Fujian 350108, PR China
| | - Peng Xu
- College of Biological Science and Engineering, Fuzhou University, Fuzhou, Fujian 350108, PR China; Fujian Key Laboratory of Marine Enzyme Engineering, Fuzhou University, Fuzhou, Fujian 350108, PR China.
| | - Mingdong Huang
- College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, PR China.
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Tambuzzi S, Gentile G, Andreola S, Migliorini AS, Zoja R. Visceral Microscopic Pattern From Suicidal Ingestion of Professional Lysoform® With Delayed Death. Acad Forensic Pathol 2022; 12:118-125. [PMID: 36093372 PMCID: PMC9459401 DOI: 10.1177/19253621221119081] [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: 02/21/2022] [Accepted: 07/24/2022] [Indexed: 08/14/2023]
Abstract
Lysoform® in the formulation of professional detergent is widely used in several fields, whereas its suicidal ingestion is an unusual occurrence. Therefore, the biological signs of this fatal poisoning remain unclear and elusive, similarly to the histological lesions induced by its main constituent, which is benzalkonium chloride (BZK). Furthermore, since all the deaths that has been reported in the literature occurred immediately, microscopic pictures of BZK lethal toxicity in subjects with prolonged survival have never been reported to date. Specifically, this brief communication reports the unique case of a woman who ingested professional Lysoform® to commit suicide, for which she died two weeks later. The autopsy examination showed either local or systemic signs of caustic ingestion; moreover, the histological analysis showed clear cellular damage of lungs, heart, and kidneys. In our case, toxicological investigations were not authorized as they were no longer considered significant. In this framework, the histological examination has therefore assumed a fundamental role in investigating and demonstrating the lethal effects caused by the systemic dissemination of BZK, which would otherwise no longer be investigable. Therefore, in cases of substance intoxication with prolonged survival where forensic toxicological investigations may be no longer possible or feasible, the histological examination may be the only resource to successfully observe and demonstrate its lethal effects.
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Affiliation(s)
| | - Guendalina Gentile
- Guendalina Gentile BSc, Sezione di Medicina
Legale—Dipartimento di Scienze Biomediche per la Salute—Università degli Studi, via Luigi
Mangiagalli, 37, 20133 Milano, Italy,
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Accidental injection of ethylenediaminetetraacetic acid (EDTA) instead of an anaesthetic solution: a case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:77-79. [PMID: 30940531 DOI: 10.1016/j.jormas.2019.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/11/2019] [Accepted: 03/25/2019] [Indexed: 11/21/2022]
Abstract
The accidental use of drugs is an unacceptable mistake in medicine, but the misuse of different agents has been reported frequently in the literature. While performing local anesthesia before starting dental treatment, the injection of a wrong agent, as a result of confusing the liquid in the syringe may cause local and systemic complications. Sudden swelling, intense pain, and severe allergic reactions may develop in the patient. A complication causing soft tissue necrosis is presented in this case report in which Ethylenediaminetetraacetic acid (EDTA) was accidentally injected instead of an anesthetic solution. This case report is unique because it is the first to report an inadvertent injection of EDTA in dentistry.
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Verma P, Tordik P, Nosrat A. Hazards of Improper Dispensary: Literature Review and Report of an Accidental Chloroform Injection. J Endod 2018; 44:1042-1047. [PMID: 29703617 DOI: 10.1016/j.joen.2018.02.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/19/2018] [Accepted: 02/26/2018] [Indexed: 12/22/2022]
Abstract
Several clear, transparent solutions are used in endodontics. Inappropriate dispensing methods can lead to accidental injection or accidental irrigation. These accidents can cause permanent tissue damage including damage to the bone, periodontium, nerves, and vasculature. This article reports on the consequences of an accidental chloroform injection. Nonsurgical retreatment of tooth #8 was planned as part of a restorative treatment plan in a 69-year-old woman. The dentist accidentally injected chloroform instead of local anesthesia because chloroform was loaded into the anesthetic syringe. The patient experienced severe pain and swelling and soft tissue necrosis and suffered permanent sensory and motor nerve damage. A review of the literature was performed on accidents caused by improper dispensary, namely accidental injections and accidental irrigations. The data were extracted and summarized. Sodium hypochlorite, chlorhexidine, formalin, formocresol, 1:1000 adrenaline, benzalkonium chloride, and lighter fuel were accidentally injected as an intraoral nerve block or as infiltration injections. Bone and soft tissue necrosis, tooth loss, and sensory nerve damage (anesthesia and paresthesia) were the most common consequences reported. Such disastrous events can be prevented by appropriate labeling and separate dispensing methods for each solution. There is a need for disseminating information on toxicity and biocompatibility of materials/solutions used in endodontics. The authors recommend training dental students and endodontic residents on immediate and long-term therapeutic management of patients when an accidental injection or accidental irrigation occurs.
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Affiliation(s)
- Prashant Verma
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland.
| | - Patricia Tordik
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Ali Nosrat
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland; Iranian Center for Endodontic Research, Dental Research Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Toxic effect in the lungs of rats after inhalation exposure to benzalkonium chloride. Int J Occup Med Environ Health 2014; 26:647-56. [PMID: 24288119 DOI: 10.2478/s13382-013-0137-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 09/03/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Benzalkonium chloride (BAC) is a quaternary ammonium compound (QAC) toxic to microorganisms. Inhalation is one of the major possible routes of human exposure to BAC. MATERIALS AND METHODS Experiments were performed on female Wistar rats. The rats were exposed to aerosol of BAC water solution at the target concentration of 0 (control group) and 35 mg/m(3) for 5 days (6 h/day) and, after a 2-week interval, the animals were challenged (day 21) with BAC aerosol at the target concentration of 0 (control group) and 35 mg/m3 for 6 h. RESULTS Compared to the controls, the animals exposed to BAC aerosol were characterized by lower food intake and their body weight was significantly smaller. As regards BAC-exposed group, a significant increase was noted in relative lung mass, total protein concentration, and MIP-2 in BALF both directly after the termination of the exposure and 18 h afterwards. Significantly higher IL-6 and IgE concentrations in BALF and a decrease in the CC16 concentration in BALF were found in the exposed group immediately after the exposure. The leukocyte count in BALF was significantly higher in the animals exposed to BAC aerosol compared to the controls. In the lungs of rats exposed to BAC the following effects were observed: minimal perivascular, interstitial edema, focal aggregates of alveolar macrophages, interstitial mononuclear cell infiltrations, thickened alveolar septa and marginal lipoproteinosis. CONCLUSION Inhalation of BAC induced a strong inflammatory response and a damage to the blood-air barrier. Reduced concentrations of CC16, which is an immunosuppressive and anti-inflammatory protein, in combination with increased IgE concentrations in BALF may be indicative of the immuno-inflammatory response in the animals exposed to BAC aerosol by inhalation. Histopathological examinations of tissue samples from the BAC-exposed rats revealed a number of pathological changes found only in the lungs.
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