Synthesis and antibacterial activities of quaternary ammonium salt of chitosan

The Effectiveness of PELNACTM Combined with Physical Antibacterial Spray in Repairing Secondary Wounds of Facial Bumps: A Pilot Randomized Clinical Trial

BACKGROUND

This study aimed to report the clinical effectiveness advantages of absorbable dressing (PELNACTM) combined with physical antibacterial spray dressing in repairing secondary wounds from facial bumps.

METHODS

Thirty-two patients comprising 20 in the experimental and 12 in the control group, respectively, were randomly selected. They had undergone excision or extended excision of facial bumps with wounds that could not be directly sutured. In the experimental group, after mass excision, the wounds were covered with PELNACTM. In the control group, secondary wounds were repaired by skin grafts or skin flaps after mass excision or extended excision. The postoperative infection rate, healing rate, average healing time, scar formation, and sensory recovery were compared between the two groups.

RESULTS

The wound infection rate in the experimental group was significantly lower than in the control group (P<0.05); the surgery time for the experimental group was shortened by 1.5 h compared to the control group (P<0.05). Four weeks after surgery, all wounds in the experimental group had healed, with a significantly higher healing rate than in the control group (P<0.05). During follow-up, the scar scores in the experimental group were significantly lower than those in the control group (P<0.05).

CONCLUSION

The combination of PELNACTM and physical antibacterial spray dressing in the repair of secondary wounds from facial bumps significantly reduced the incidence of wound infection, accelerated wound healing, reduced scar formation at the graft site, and minimized surgical trauma to the donor site.

LEVEL OF EVIDENCE I

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MNN45 is involved in Zcf31-mediated cell surface integrity and chitosan susceptibility in Candida albicans

Candida albicans is a major human fungal pathogen; however, limited antifungal agents, undesirable drug side effects, and ineffective prevention of drug-resistant strains have become serious problems. Chitosan is a nontoxic, biodegradable, and biocompatible linear polysaccharide made from the deacetylation of chitin. In this study, a ZCF31 putative transcription factor gene was selected from a previous mutant library screen, as zcf31Δ strains exhibited defective cell growth in response to chitosan. Furthermore, chitosan caused notable damage to zcf31Δ cells; however, ZCF31 expression was not significantly changed by chitosan, suggesting that zcf31Δ is sensitive to chitosan could be due to changes in the physical properties of C. albicans. Indeed, zcf31Δ cells displayed significant increases in cell wall thickness. Consistent with the previous study, zcf31Δ strains were resistant to calcofluor white but highly susceptible to SDS (sodium dodecyl sulfate). These results implied that chitosan mainly influences membrane function, as zcf31Δ strengthens the stress resistance of the fungal cell wall but lessens cell membrane function. Interestingly, this effect on the cell surface mechanics of the C. albicans zcf31Δ strains was not responsible for the virulence-associated function. RNA-seq analysis further revealed that six mannosyltransferase-related genes were upregulated in zcf31Δ. Although five mannosyltransferase-related mutant strains in the zcf31Δ background partially reduced the cell wall thickness, only zcf31Δ/mnn45Δ showed the recovery of chitosan resistance. Our findings suggest that Zcf31 mediates a delicate and complicated dynamic balance between the cell membrane and cell wall architectures through the mannosyltransferase genes in C. albicans, leading to altered chitosan susceptibility.

Chitosan and Its Nanoparticles: A Multifaceted Approach to Antibacterial Applications

Chitosan, a multifaceted amino polysaccharide biopolymer derived from chitin, has extensive antibacterial efficacy against diverse pathogenic microorganisms, including both Gram-negative and Gram-positive bacteria, in addition to fungi. Over the course of the last several decades, chitosan nanoparticles (NPs), which are polymeric and bio-based, have garnered a great deal of interest as efficient antibacterial agents. This is mostly due to the fact that they are used in a wide variety of applications, including medical treatments, food, chemicals, and agricultural products. Within the context of the antibacterial mechanism of chitosan and chitosan NPs, we present a review that provides an overview of the synthesis methods, including novel procedures, and compiles the applications that have been developed in the field of biomedicine. These applications include wound healing, drug delivery, dental treatment, water purification, agriculture, and food preservation. In addition to this, we focus on the mechanisms of action and the factors that determine the antibacterial activity of chitosan and its derivatives. In conjunction with this line of inquiry, researchers are strongly urged to concentrate their efforts on developing novel and ground-breaking applications of chitosan NPs.

Chitosan Micro/Nanocapsules in Action: Linking Design, Production, and Therapeutic Application

pH sensitivity of chitosan allows for precise phase transitions in acidic environments, controlling swelling and shrinking, making chitosan suitable for drug delivery systems. pH transitions are modulated by the presence of cross-linkers by the functionalization of the chitosan chain. This review relays a summary of chitosan functionalization and tailoring to optimize drug release. The potential to customize chitosan for different environments and therapeutic uses introduces opportunities for drug encapsulation and release. The focus on improving drug encapsulation and sustained release in specific tissues is an advanced interpretation, reflecting the evolving role of chitosan in achieving targeted and more efficient therapeutic outcomes. This review describes strategies to improve solubility and stability and ensure the controlled release of encapsulated drugs. The discussion on optimizing factors like cross-linking density, particle size, and pH for controlled drug release introduces a deeper understanding of how to achieve specific therapeutic effects. These strategies represent a refined approach to designing chitosan-based systems, pushing the boundaries of sustained release technologies and offering new avenues for precise drug delivery profiles.

Antibacterial activity of polyethylene film by hyperthermal hydrogen induced cross-linking with chitosan quaternary ammonium salt

In this study, hyperthermal hydrogen-induced cross-linking (HHIC) technology was applied to construct a dense cross-linking layer of antibacterial chitosan quaternary ammonium salt (HTCC) to PE surface through the selective cleavage of CH bonds and subsequent cross-linking of the resulting carbon radicals. Before HHIC treatment, UV-Ozone was used to activate PE surface to facilitate HTCC adsorption. FT-IR and XPS analyses proved the successful cross-linking between PE and HTCC. From AFM analysis, the prepared PE cross-linked HTCC film (PE-c-HTCC) showed the rougher surface with average roughness (Ra) of 9.16 nm. The water vapor permeability (WVP) and oxygen permeability (OP) values of the film were decreased by about 83 % and 97 %, respectively. Additionally, the film exhibited strong antibacterial properties against E. coli and S. aureus. In terms of these properties, the shelf life of fresh beef could be extended for 2 days after packing with the PE-c-HTCC film.

Stimuli-responsive chitosan based nanoparticles in cancer therapy and diagnosis: A review

Chitosan, obtained through deacetylation of chitin, has been shown to a promising biopolymer for the development of nano- and micro-particles. In spite of inherent anti-cancer activity of chitosan, the employment of this carbohydrate polymer for the synthesis of nanoparticles opens a new gate in disease therapy. The properties of chitosan including biocompatibility, biodegradability, and modifiability are vital in enhancing these nanoparticles, allowing for improved solubility and interaction with cellular targets. Among the pathological events, cancer has demonstrated an increase in incidence rate and therefore, the chitosan nanoparticles have been significantly utilized in cancer therapy. The present review emphasizes on the role of stimuli-responsive chitosan nanoparticles in the field of cancer therapy. The stimuli-responsive nanoparticles can release the cargo in the tumor site that not only improves the anti-cancer activity of chemotherapy drugs, but also diminishes their systemic toxicity. The stimuli-responsive chitosan nanoparticles can respond to endogenous and exogenous stimuli including pH, redox and light to release cargo. This improves the specificity towards tumor cells and enhances accumulation of drugs and/or drugs. The light-responsive chitosan nanoparticles can cause photothermal and photodynamic therapy in tumor ablation and provide theranostic feature that is cancer diagnosis and therapy simultaneously.

Fine-tuning the cytotoxicity profile of N,N,N-trimethyl chitosan through trimethylation, molecular weight, and polyelectrolyte complex nanoparticles

N,N,N-trimethyl chitosan (TMC) is a promising biopolymer for pharmaceutical applications due to its enhanced solubility and bioadhesive properties, though its cytotoxic limitations necessitate careful modification to ensure safety and efficacy. This study sought to investigate whether nanoparticle (NP) formation could reduce the anticipated cytotoxic effects of TMC, thus improving its applicability across a wider spectrum of pharmaceutical uses. TMC's capability to form NPs with anionic polyelectrolytes led to the application of chondroitin sulfate (ChS) in this study. Five TMC samples, varying in degree of trimethylation (DTM 23, 32, 46, 50 and 99 %) and molecular weight (Mw, 66-290 kDa) were synthesized, and their biocompatibility with human umbilical vein endothelial cells (HUVECs) was assessed. The results revealed a discernible impact of both DTM and Mw on cell viability, with higher DTM and lower Mw correlating with increased toxicity. Cytotoxicity studies against ovarian cancer cell lines SKOV-3 and OVISE showed a clear indication of a higher cytotoxic effect of TMC samples against cancer cells compared to healthy cells (HUVEC). The cytotoxicity against cancer cells also indicated an optimal DTM for maximum efficacy, deviating from a linear trend. The effects of Mw were cell-dependent, introducing complexity to the observed relationship. Additionally, TMC-ChS NPs were successfully prepared, demonstrating a substantial reduction in cytotoxicity compared to TMC alone in all tested cells. This promising outcome suggests the potential of NP formation to fine-tune the cytotoxicity profile of TMC, paving the way for the development of safer and more effective pharmaceutical formulations.

A review of polysaccharide hydrogels as materials for skin repair and wound dressing: Construction, functionalization and challenges

Hydrogels can imitate the extracellular matrix, therefore facilitating the creation of an ideal healing environment for wounds. Consequently, they are popular as a material choice for wound dressings. Polysaccharides have been widely used in wound dressings due to their good biocompatibility and degradability. In this study, we first discuss skin and wound physiology before summarizing the methods for producing hydrogels from polysaccharides and their derivatized. These include not just normal polysaccharides like chitosan, cellulose, and alginate, but also Chinese medicinal polysaccharides with therapeutic properties. Then, strategies for causing hydrogel production from polysaccharides or their derivatives are briefly explained. Finally, the functions of hydrogel dressings are reviewed, including antibacterial, antioxidant, and adhesive properties, as well as the methods for achieving these properties. Furthermore, current issues and concerns are discussed, with the goal of providing fresh paths for the development of future wound dressings.

Synthesis of Quarternized Chitosans and Their Potential Applications in the Solubility Enhancement of Indomethacin by Solid Dispersion

This study was designed to synthesize quarternized chitosans (Q-CS) and explore their potential application in aqueous solubility enhancement of indomethacin (IND), a BCS class-II drug. Three different Q-CS; N,N,N-trimethyl chitosan chloride (TMC), N-(4-N'-methylpyridinylmethyl) chitosan chloride (mPyCS), and N-(4-N',N',N'-trimethylaminobenzyl) chitosan chloride (TmBzCS) were synthesized and characterized through various spectroscopic analysis. Q-CS-based solid-dispersion (SD) composites of IND (Q-CS-IND) were prepared using the spray-drying method and characterized through Fourier transform infrared (FTIR), scanning electron microscopy (SEM), differential-scanning calorimetry (DSC), and powder X-ray diffraction (P-XRD). The solubility and dissolution profiles of SD-composites of IND were evaluated and compared with physical mixtures (PM). The IND contents were quantified and validated in the composites using UV-Vis spectrophotometer. FTIR and NMR analysis showed the successful preparation of Q-CS. TMC was found with the highest yield (55.13%) and mPyCS with the highest degree of quaternization (DQ) (63.37%). FT-IR analysis of IND-Q-CS composites demonstrated chemical interaction between carbonyl moieties of IND with functional groups of Q-CS. DSC and PXRD analyses demonstrated the transformation of IND in SD composites from crystalline to an amorphous form. All the IND-Q-CS composites were observed with a significant increase in the solubility and dissolution rate of the drug (1996.0 µg/min) compared to PM (1306.8 µg/min), which is higher than pure IND (791.6 µg/min). The contents of IND in TMC, mPyCS, and TmBzCS composites were 97.69-99.92%, 97.66-100.25%, and 97.18-100.11% respectively. Overall, the findings encourage the applications of Q-CS derivatives for increasing IND water solubility and warrant further in vivo biological profiling of IND composites.

Synthesis and unambiguous NMR characterization of linear and branched N-alkyl chitosan derivatives

Chitosan, sourced from abundant chitin-rich waste streams, emerges as a promising candidate in the realm of future functional materials and chemicals. While showing numerous advantageous properties, chitosan sometimes falls short of competing with today's non-renewable alternatives. Chemical derivatization, particularly through N-alkylation, proves promising in enhancing hydrophobic functionalities. This study synthesizes fifteen chitosan derivatives (degree of substitution = 2-10 %) using an improved reductive amination method. Next, selective depolymerization through acid hydrolysis reduced the chain rigidity imposed by the polymer backbone. This facilitated unambiguous structural characterization of the synthesized compounds using a combination of common NMR techniques. Two potential side reactions are identified for the first time, emphasizing the need for detailed structural information to unlock the true potential of these derivatives in future applications. HYPOTHESIS: The increase in chain mobility induced by the selective depolymerization of aliphatic N-alkyl chitosan derivatives allows for an unambiguous NMR characterization.

Chitosan-coated liposomal systems for delivery of antibacterial peptide LL17-32 to Porphyromonas gingivalis

Periodontal disease is triggered by surface bacterial biofilms where bacteria are less susceptible to antibiotic treatment. The development of liposome-based delivery mechanisms for the therapeutic use of antimicrobial peptides is an attractive alternative in this regard. The cationic antimicrobial peptide LL-37 (human cathelicidin) is well-known to exert antibacterial activity against P orphyromonas gingivalis, a keystone oral pathogen. However, the antibacterial activity of the 16-amino acid fragment (LL17-32) of LL-37, is unknown. In addition, there are still gaps in studies using liposomal formulations as delivery vehicles of antibacterial peptides against this pathogen. This study was designed to examine the influence of the different types of liposomal formulations to associate and deliver LL17-32 to act against P. gingivalis. Chitosans of varying Mw and degree of acetylation (DA) were adsorbed at the surface of soya lecithin (SL) liposomes. Their bulk (average hydrodynamic size, ζ-potential and membrane fluidity) and ultrastructural (d-spacing, half-bilayer thickness and the water layer thickness) biophysical properties were investigated by a panel of techniques (DLS, SAXS, M3-PALS, fluorescence spectroscopy and TEM imaging). Their association efficiency, in vitro release, stability, and efficacy in killing the periodontal pathogen P. gingivalis were also investigated. All liposomal systems possessed spherical morphologies and good shelf-life stabilities. Under physiological conditions, chitosan formulations with a high DA demonstrated enhanced stability in comparison to low DA-chitosan formulations. Chitosans and LL17-32 both decreased SL-liposomal membrane fluidity. LL17-32 exhibited a high degree of association with SL-liposomes without in vitro release. In biological studies, free LL17-32 or chitosans alone, demonstrated microbicidal activity against P. gingivalis, however this was attenuated when LL17-32 was loaded onto the SL-liposome delivery system, presumably due to the restrained release of the peptide. A property that could be harnessed in future studies (e.g., oral mucoadhesive slow-release formulations).

Chitosan- and hyaluronic acid-based nanoarchitectures in phototherapy: Combination cancer chemotherapy, immunotherapy and gene therapy

Cancer phototherapy has been introduced as a new potential modality for tumor suppression. However, the efficacy of phototherapy has been limited due to a lack of targeted delivery of photosensitizers. Therefore, the application of biocompatible and multifunctional nanoparticles in phototherapy is appreciated. Chitosan (CS) as a cationic polymer and hyaluronic acid (HA) as a CD44-targeting agent are two widely utilized polymers in nanoparticle synthesis and functionalization. The current review focuses on the application of HA and CS nanostructures in cancer phototherapy. These nanocarriers can be used in phototherapy to induce hyperthermia and singlet oxygen generation for tumor ablation. CS and HA can be used for the synthesis of nanostructures, or they can functionalize other kinds of nanostructures used for phototherapy, such as gold nanorods. The HA and CS nanostructures can combine chemotherapy or immunotherapy with phototherapy to augment tumor suppression. Moreover, the CS nanostructures can be functionalized with HA for specific cancer phototherapy. The CS and HA nanostructures promote the cellular uptake of genes and photosensitizers to facilitate gene therapy and phototherapy. Such nanostructures specifically stimulate phototherapy at the tumor site, with particle toxic impacts on normal cells. Moreover, CS and HA nanostructures demonstrate high biocompatibility for further clinical applications.

Quaternized chitosan/polyvinyl alcohol anion exchange membrane enhanced by functionalized attapulgite clay with an ionic "chain-ball" surface structure

Biomass chitosan has garnered considerable interest for alkaline anion exchange membranes (AEMs) due to its eco-friendly and sustainable characteristics, low reactant permeability and easily modifiable nature, but it still faces the trade-off between high hydroxide conductivity and sufficient mechanical properties. Herein, a novel functionalized attapulgite clay (f-ATP) with a unique ionic "chain-ball" surface structure was prepared and incorporated with quaternized chitosan (QCS)/polyvinyl alcohol (PVA) matrix to fabricate high-performance composite AEMs. Due to the strengthened interfacial bonding between f-ATP nanofillers and the QCS/PVA matrix, composite membranes are synergistically reinforced and toughened, achieving peak tensile strength and elongation at break of 24.62 MPa and 33.8 %. Meanwhile, abundant ion pairs on f-ATP surface facilitate ion transport in the composite AEMs, with the maximum OH- conductivity of 46 mS cm-1 at 80 °C and the highest residual IEC of 83 % after alkaline treatment for 120 h. Moreover, the assembled alkaline direct methanol fuel cell exhibits a remarkable power density of 49.3 mW cm-2 at 80 °C. This work provides a new strategy for fabricating high-performance anion exchange membranes.

Quaternary ammonium carboxymethyl chitosan composite hydrogel with efficient antibacterial and antioxidant properties for promoting wound healing

Multifunctional hydrogels have been developed to meet the various requirements of wound healing. Herein, an innovative hydrogel (QCMC-HA-PEG) was formed through the Schiff base reaction, composed of quaternary ammonium-modified carboxymethyl chitosan (QCMC), hyaluronic acid (HA), and 8-arms Polyethylene Glycol aldehyde (8-ARM-PEG-CHO). The resulting hydrogels exhibited good mechanical and adhesive properties with improved antibacterial efficacy against both Gram-positive and Gram-negative bacteria compared to CMC hydrogels. QCMC-HA-PEG hydrogels demonstrated remarkable adhesive ability in lap-shear test. Furthermore, the incorporation of MnO2 nanosheets into the hydrogel significantly enhanced its reactive oxygen species (ROS) scavenging and oxygen generation capabilities. Finally, experimental results from a full-thickness skin wound model revealed that the QCMC-HA-PEG@MnO2 hydrogel promoted skin epithelization, collagen deposition, and inflammatory regulation significantly accelerated the wound healing process. Therefore, QCMC-HA-PEG@MnO2 hydrogel could be a promising wound dressing to promote wound healing.

Research Advances in Superabsorbent Polymers

Superabsorbent polymers are new functional polymeric materials that can absorb and retain liquids thousands of times their masses. This paper reviews the synthesis and modification methods of different superabsorbent polymers, summarizes the processing methods for different forms of superabsorbent polymers, and organizes the applications and research progress of superabsorbent polymers in industrial, agricultural, and biomedical industries. Synthetic polymers like polyacrylic acid, polyacrylamide, polyacrylonitrile, and polyvinyl alcohol exhibit superior water absorption properties compared to natural polymers such as cellulose, chitosan, and starch, but they also do not degrade easily. Consequently, it is often necessary to modify synthetic polymers or graft superabsorbent functional groups onto natural polymers, and then crosslink them to balance the properties of material. Compared to the widely used superabsorbent nanoparticles, research on superabsorbent fibers and gels is on the rise, and they are particularly notable in biomedical fields like drug delivery, wound dressing, and tissue engineering.

Enhancing Chitosan Fibers: A Dual Approach with Tripolyphosphate and Ursolic Acid

Chitosan, a well-established biomaterial known for its biocompatibility, biodegradability, and bioactivity, has been the focus of extensive research in recent years. This study explores the enhancement of chitosan fibers' properties through wet impregnation with either ursolic acid (UA) or cross-linking with tripolyphosphate (TPP). In the first experiment, chitosan fibers were treated with UA, for varying immersion set points (1, 2, 4, 6, and 8 h). FTIR, SEM, and UV-Vis spectroscopy analyses demonstrated a chemical reaction between chitosan and UA, with stability reached after 2 h of immersion. Antibacterial testing revealed that chitosan fibers impregnated with UA exhibited significant antibacterial activity against Gram-positive bacteria, notably Staphylococcus aureus. The second experiment involved modifying chitosan fibers' surfaces with a 1% w/v TPP solution for the same periods of time (1, 2, 4, 6, and 8 h). Subsequently, the investigation involved FTIR, SEM, and dynamometry analyses, which revealed successful cross-linking between chitosan and TPP ions, resulting in improved tensile strength after 2 h of immersion. This dual-approach study highlights the potential of chitosan fibers for diverse applications, from wound-healing dressings to antibacterial materials against Gram-positive bacteria.

Quaternary-ammonium chitosan, a promising packaging material in the food industry

Quaternary-ammonium chitosan (QAC) is a polysaccharide with good water solubility, bacteriostasis, and biocompatibility. QAC is obtained by methylating or grafting the quaternary-ammonium group of chitosan and is an important compound in the food industry. Various QAC-based complexes have been prepared using reversible intermolecular interactions, such as electrostatic interactions, hydrogen bonding, metal coordination, host-guest interactions, and covalent bonding interactions consisting of Schiff base bonding and dynamic chemical bond cross-linking. In the food industry, QAC is often used as a substrate in film or coating for food preservation and as a carrier for active substances to improve the encapsulation efficiency and storage stability of functional food ingredients. In this review, we have assimilated the latest information on QAC to facilitate further discussions and future research. Advancement in research on QAC would contribute toward technology acceleration and its increased contribution to the field of food technology.

Extraction and characterization of Chitosan from Shell of Borassus flabellifer and their antibacterial and antioxidant applications

Chitosan is a bio-polymer made up of repeating units of N-acetyl glucosamine and glucosamine joined together by (1-4)-glycosidic linkages. Various bioresources have been used to develop bioactive materials that have a wide range of applications in different fields, including industry and medicine. Borassus flabellifer is a well-known source of chitin in the sub-Indian continent and is used in digestion, pharmaceuticals, and other applications. Chitin can be extracted from B. flabellifer fruit shells through demineralization and deproteinization and then converted into chitosan through deacetylation. This study aimed to investigate the biological activity of chitosan extracted from B. flabellifer fruit shells and to analyze its molecular structure using FT-IR analysis. Results showed the presence of NH, OH, and CO stretching, indicating the presence of various functional groups in chitosan. Scanning electron microscopic study revealed the topography of the chitosan. Well-diffusion and MIC tests showed that chitosan exhibited activity against E. coli and S. aureus. The chitosan extract also exhibited potential antioxidant polymer by scavenging free radicals.

Applications of Chitosan Nanoparticles in Dentistry: A Review

Recently, nanotechnology has garnered significant interest across various fields due to its emerging and diverse applications. Numerous investigators have proposed that chitosan nanoparticles (CSNPs) stand out as some of the most promising nanomaterials for facilitating various activities. Chitosan, a natural biopolymer established through the deacetylation of chitin, has been extensively studied using interdisciplinary approaches for a wide range of applications. Chitosan biomaterials exhibit distinctive attributes, including biodegradability, muco-adhesion, and biocompatibility, as well as a broad spectrum of antibacterial and antifungal properties. Furthermore, chitosan stands as the sole naturally occurring cationic polysaccharide, and it can be chemically tailored into various derivatives, depending on the intended role and utilization. The potential applications of chitosan are vast and intriguing, with many yet to be fully explored and understood. The unique characteristics of chitosan have sparked growing attentiveness in pharmaceutical industries and biomedical areas around the globe. The characteristics of chitosan like its biocompatibility, and anti-inflammatory effects hold the potential to yield promising outcomes in wound healing and periodontal care following tooth extractions. The objective of this study is to provide an overview of potential applications of chitosan in the field of dentistry.

Cationic Chitosan Derivatives for the Inactivation of HIV-1 and SARS-CoV-2 Enveloped Viruses

Cationic chitosan derivatives have been widely studied as potential antimicrobial agents. However, very little is known about their antiviral activity and mode of action against enveloped viruses. We investigated the ability of hydroxypropanoic acid-grafted chitosan (HPA-CS) and N-(2-hydroxypropyl)-3-trimethylammonium chitosan chloride (HTCC) to inactivate enveloped viruses like the human immunodeficiency virus (HIV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The membrane-disrupting potential of the chitosan derivatives was initially investigated in a hemolysis assay. At 1.0 mg/mL, about 80% hemolysis was observed for the cationic chitosan derivatives, which was significant when compared to almost no membrane-disrupting activity by the unmodified chitosan. Virus inhibition was evaluated using the luciferase-based antiviral assay against the HIV-1 NL4.3 virus (400 TCID). The IC50 of HPA-CS was 4.109 mg/mL, while the HTCC showed a higher antiviral activity at an IC50 = 0.225 mg/mL. For practical application, the antiviral efficacies of the HTCC-coated and uncoated nonmedical masks were evaluated for SARS- CoV-2 virus capture. The coated masks demonstrated an almost excellent performance with nearly 100% viral inhibition compared to less than 60% inhibition by the uncoated masks. Molecular docking predictions suggest that the HTCC polymers interact with the viral spike protein, blocking the coronavirus interaction with the target host cell's angiotensin-converting enzyme 2 cellular receptors.

Biocompatible Chitosan Films Containing Acetic Acid Manifested Potent Antiviral Activity against Enveloped and Non-Enveloped Viruses

Chitosan films were prepared by solvent casting using an acetic acid-based solution. The films that were developed contained 15.49% of acetic acid solution (10% v/v) and showed biocompatibility in vitro in human keratinocyte HaCaT cells and potent antiviral activity against both enveloped and non-enveloped viruses. The results showed up to 99.98% and 99.92% viral inactivation against the phi 6 enveloped bacteriophage and MS2 non-enveloped bacteriophage, respectively, suggesting that this chitosan/acetic acid film is a promising material for biomedical applications that require biodegradable broad-spectrum antiviral materials.

Chitosan-induced biotic stress tolerance and crosstalk with phytohormones, antioxidants, and other signalling molecules

Several polysaccharides augment plant growth and productivity and galvanise defence against pathogens. Such elicitors have ecological superiority over traditional growth regulators, considering their amplified biocompatibility, biodegradability, bioactivity, non-toxicity, ubiquity, and inexpensiveness. Chitosan is a chitin-derived polysaccharide that has recently been spotlighted among plant scientists. Chitosan supports plant growth and development and protects against microbial entities such as fungi, bacteria, viruses, nematodes, and insects. In this review, we discuss the current knowledge of chitosan's antimicrobial and insecticidal potential with recent updates. These effects are further explored with the possibilities of chitosan's active correspondence with phytohormones such as jasmonic acid (JA), salicylic acid (SA), indole acetic acid (IAA), abscisic acid (ABA), and gibberellic acid (GA). The stress-induced redox shift in cellular organelles could be substantiated by the intricate participation of chitosan with reactive oxygen species (ROS) and antioxidant metabolism, including hydrogen peroxide (H2O2), superoxide dismutase (SOD), catalase (CAT), and peroxidase (POD). Furthermore, we propose how chitosan could be intertwined with cellular signalling through Ca2+, ROS, nitric oxide (NO), transcription factors (TFs), and defensive gene activation.

Current and emerging applications of saccharide-modified chitosan: a critical review

Chitin, as the main component of the exoskeleton of Arthropoda, is a highly available natural polymer that can be processed into various value-added products. Its most important derivative, i.e., chitosan, comprising β-1,4-linked 2-amino-2-deoxy-β-d-glucose (deacetylated d-glucosamine) and N-acetyl-d-glucosamine units, can be prepared via alkaline deacetylation process. Chitosan has been used as a biodegradable, biocompatible, non-antigenic, and nontoxic polymer in some in-vitro applications, but the recently found potentials of chitosan for in-vivo applications based on its biological activities, especially antimicrobial, antioxidant, and anticancer activities, have upgraded the chitosan roles in biomaterials. Chitosan approval, generally recognized as a safe compound by the United States Food and Drug Administration, has attracted much attention toward its possible applications in diverse fields, especially biomedicine and agriculture. Even with some favorable characteristics, the chitosan's structure should be customized for advanced applications, especially due to its drawbacks, such as low drug-load capacity, low solubility, high viscosity, lack of elastic properties, and pH sensitivity. In this context, derivatization with relatively inexpensive and highly available mono- and di-saccharides to soluble branched chitosan has been considered a "game changer". This review critically reviews the emerging technologies based on the synthesis and application of lactose- and galactose-modified chitosan as two important chitosan derivatives. Some characteristics of chitosan derivatives and biological activities have been detailed first to understand the value of these natural polymers. Second, the saccharide modification of chitosan has been discussed briefly. Finally, the applications of lactose- and galactose-modified chitosan have been scrutinized and compared to native chitosan to provide an insight into the current state-of-the research for stimulating new ideas with the potential of filling research gaps.

Chitosan decorated essential oil nanoemulsions for enhanced antibacterial activity using a microfluidic device and response surface methodology

In this work, the antibacterial activity of Satureja Khuzestanica essential oil nanoemulsions improved by employing chitosan (ch/SKEO NE) against E. coli bacterium. The optimum ch/SKEO NE with mean droplet size of 68 nm was attained at 1.97, 1.23, and 0.10%w/w of surfactant, essential oil and chitosan, using Response Surface Methodology (RSM). Applying microfluidic platform, the ch/SKEO NE resulted in improved antibacterial activity owing to the modification of surface properties. The nanoemulsion samples showed a significant rupturing effect on the E. coli bacterial cell membrane which resulted in a rapid release of cellular contents. This action was remarkably intensified by executing microfluidic chip in parallel to the conventional method. Having treated the bacteria in the microfluidic chip for 5 min with a 8 μg/mL concentration of ch/SKEO NE, the bacterial integrity disrupted quickly, and the activity was totally lost in a 10-min period at 37 μg/mL, while it took 5 h for a complete inhibition in the conventional method using the same concentration of ch/SKEO NE. It can be concluded that nanoemulsification of EOs using chitosan coating can intensify the interaction of nanodroplets with the bacterial membrane, especially within the microfluidic chips which provides high contact surface area.

The Progress of Chitosan-Based Nanoparticles for Intravesical Bladder Cancer Treatment

Bladder cancer (BC) is the most frequently occurring cancer of the urinary system, with non-muscle-invasive bladder cancer (NMIBC) accounting for 75-85% of all the bladder cancers. Patients with NMIBC have a good survival rate but are at high risk for tumor recurrence and disease progression. Intravesical instillation of antitumor agents is the standard treatment for NMIBC following transurethral resection of bladder tumors. Chemotherapeutic drugs are broadly employed for bladder cancer treatment, but have limited efficacy due to chemo-resistance and systemic toxicity. Additionally, the periodic voiding of bladder and low permeability of the bladder urothelium impair the retention of drugs, resulting in a weak antitumoral response. Chitosan is a non-toxic and biocompatible polymer which enables better penetration of specific drugs to the deeper cell layers of the bladder as a consequence of temporarily abolishing the barrier function of urothelium, thus offering multifaceted biomedical applications in urinary bladder epithelial. Nowadays, the rapid development of nanoparticles significantly improves the tumor therapy with enhanced drug transport. This review presents an overview on the state of chitosan-based nanoparticles in the field of intravesical bladder cancer treatment.

Recent advances of polymer based nanosystems in cancer management

Cancer is still one of the leading causes of death worldwide. Nanotechnology, particularly nanoparticle-based platforms, is at the leading edge of current cancer management research. Polymer-based nanosystems have piqued the interest of researchers owing to their many benefits over other conventional drug delivery systems. Polymers derived from both natural and synthetic sources have various biomedical applications due to unique qualities like porosity, mechanical strength, biocompatibility, and biodegradability. Polymers such as poly(lactic-co-glycolic acid) (PLGA), polycaprolactone (PCL), and polyethylene glycol (PEG) have been approved by the USFDA and are being researched for drug delivery applications. They have been reported to be potential carriers for drug loading and are used in theranostic applications. In this review, we have primarily focused on the aforementioned polymers and their conjugates. In addition, the therapeutic and diagnostic implications of polymer-based nanosystems have been briefly reviewed. Furthermore, the safety of the developed polymeric formulations is crucial, and we have discussed their biocompatibility in detail. This article also discusses recent developments in block co-polymer-based nanosystems for cancer treatment. The review ends with the challenges of clinical translation of polymer-based nanosystems in drug delivery for cancer therapy.

Cationic Chitooligosaccharide Derivatives Bearing Pyridinium and Trialkyl Ammonium: Preparation, Characterization and Antimicrobial Activities

In this study, chitooligosaccharide-niacin acid conjugate was designed and synthesized through the reaction of chitooligosaccharide and nicotinic acid with the aid of N,N'-carbonyldiimidazole. Its cationic derivatives were prepared by the further nucleophilic substitution reaction between the chitooligosaccharide-niacin acid conjugate and bromopropyl trialkyl ammonium bromide with different alkyl chain lengths. The specific structural characterization of all derivatives was identified using Fourier Transform Infrared Spectroscopy (FTIR) and Nuclear Magnetic Resonance (NMR), and the degree of substitution was obtained using the integral area ratio of the hydrogen signals. Specifically, the antibacterial activities against Escherichia coli, Staphylococcus aureus, Pseudoalteromonas citrea and Vibrio harveyi were evaluated using broth dilution methods. In addition, their antifungal activities, including Botrytis cinerea, Glomerella cingulate and Fusarium oxysporum f. sp. cubense were assayed in vitro using the mycelium growth rate method. Experimental data proved that the samples showed antibacterial activity against four pathogenic bacteria (MIC = 1-0.125 mg/mL, MBC = 8-0.5 mg/mL) and enhanced antifungal activity (50.30-68.48% at 1.0 mg/mL) against Botrytis cinerea. In particular, of all chitooligosaccharide derivatives, the chitooligosaccharide derivative containing pyridinium and tri-n-butylamine showed the strongest antibacterial capacity against all of the test pathogenic bacteria; the MIC against Vibrio harveyi was 0.125 mg/mL and the MBC was 1 mg/mL. The experimental results above showed that the introduction of pyridinium salt and quaternary ammonium salt bearing trialkyl enhanced the antimicrobial activity. In addition, the cytotoxicity against L929 cells of the chitooligosaccharide derivatives was evaluated, and the compounds exhibited slight cytotoxicity. Specifically, the cell viability was greater than 91.80% at all test concentrations. The results suggested that the cationic chitooligosaccharide derivatives bearing pyridinium and trialkyl ammonium possessed better antimicrobial activity than pure chitooligosaccharide, indicating their potential as antimicrobial agents in food, medicine, cosmetics and other fields.

Scaffolds in the microbial resistant era: Fabrication, materials, properties and tissue engineering applications

Due to microbial infections dramatically affect cell survival and increase the risk of implant failure, scaffolds produced with antimicrobial materials are now much more likely to be successful. Multidrug-resistant infections without suitable prevention strategies are increasing at an alarming rate. The ability of cells to organize, develop, differentiate, produce a functioning extracellular matrix (ECM) and create new functional tissue can all be controlled by careful control of the extracellular microenvironment. This review covers the present state of advanced strategies to develop scaffolds with antimicrobial properties for bone, oral tissue, skin, muscle, nerve, trachea, cardiac and other tissue engineering applications. The review focuses on the development of antimicrobial scaffolds against bacteria and fungi using a wide range of materials, including polymers, biopolymers, glass, ceramics and antimicrobials agents such as antibiotics, antiseptics, antimicrobial polymers, peptides, metals, carbon nanomaterials, combinatorial strategies, and includes discussions on the antimicrobial mechanisms involved in these antimicrobial approaches. The toxicological aspects of these advanced scaffolds are also analyzed to ensure future technological transfer to clinics. The main antimicrobial methods of characterizing scaffolds' antimicrobial and antibiofilm properties are described. The production methods of these porous supports, such as electrospinning, phase separation, gas foaming, the porogen method, polymerization in solution, fiber mesh coating, self-assembly, membrane lamination, freeze drying, 3D printing and bioprinting, among others, are also included in this article. These important advances in antimicrobial materials-based scaffolds for regenerative medicine offer many new promising avenues to the material design and tissue-engineering communities.

Hydroxypropyltrimethyl Ammonium Chloride Chitosan Nanoparticles Coatings for Reinforcement and Concomitant Inhibition of Anionic Water-Sensitive Dyes Migration on Fragile Paper Documents

The fragile paper is treated to improve the stability and appearance of the paper artifact, such as washing, lining, deacidification, and reinforcement. During the above treatments, paper documents inevitably make contact with water directly, leading to the appearance change, stability decrease, and migration or fading of anionic water-sensitive dyes, which are seriously harmful to information security. Herein, Hydroxypropyltrimethyl ammonium chloride chitosan (HACC) nanoparticles were employed for the reinforcement and concomitant inhibition of anionic water-sensitive dye migration on fragile paper. HACC nanoparticles were prepared through physical ball grinding method and characterized via LPSA, SEM, TEM, XRD and FTIR. To evaluate the protective potential of HACC nanoparticles coating, the chemical and mechanical properties of coated and uncoated papers were evaluated after dry heat and hygrothermal accelerated aging. Additionally, good color stability of anionic water-sensitive dyes was observed on the paper coated with HACC nanoparticles after lining technology. Finally, the interaction mechanism between the anionic water-sensitive dyes and HACC nanoparticles was analyzed using an ultraviolet spectrophotometer and FTIR. The as-proposed technique can provide technical support to improve the mechanical properties of fragile paper and enhance the anionic water-sensitive dyes stability in the aqueous phase.

Evaluation of antimicrobial activity of thiolated methylated N-(4-N, N-dimethylaminobenzyl) chitosan as a new derivative of chitosan

Despite chitosan as a natural cationic polysaccharide derived from chitin can be applied as an antimicrobial agent, many studies are performing for enhancing its capability to fight against pathogens. The aim of this study is investigating the antibacterial effect of thiolated methylated N-(4-N,N-dimethylaminobenzyl) chitosan (TTMAC) polymer and its nanoparticles as a novel derivation of chitosan. The polymer derivative was synthetized and characterized via¹ H NMR, FT-IR and Elman test. The nanoparticles with different N/P ratios were prepared by ionic gelation method and characterized by DLS (Dynamic Light Scattering) and TEM (Transmission Electron Microscopy). The cellular toxicity of polymer and nanoparticles at different concentrations were evaluated on human MCF-7 cell line. Antimicrobial assay was performed on Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923) and Candida albicans (ATCC 10231)as Gram negative, Gram positive and yeast pathogens, respectively. The obtained results have shown the TTMAC polymer has a higher inhibition activity against microbial pathogens and also lower cellular toxicity in comparison with chitosan polymer. Furthermore, chitosan nanoparticles in comparison with TTMAC nanoparticles have lower size and highest zeta potential in different ratio and chitosan nanoparticles have more inhibitory effects against microbial pathogens. In conclusion, TTMAC derivative in polymeric form can be a promising tool against microbial pathogens.

Characterization and antibacterial activity of ruthenium-based shikimate cross-linked chitosan composites

The unsustainable antibacterial activity of ruthenium antibacterial agents is an important factor limiting their applications. This present work attempts to prepare ruthenium (Ru) coordination polymer composites with chitosan quaternary ammonium polymers (CQ) and shikimic acid (SA) through the interaction of ionic bonds and covalent bonds by microwave-assisted high-pressure homogenization methods. The prepared CQ@Ru-SA was characterized by size distribution, zeta potential, TEM, UV-vis, FTIR, XPS and XRD analyses. The coordination structure and morphology of Bridge-CQ-NH-Ru-SA were verified. The CQ@Ru-SA was well-dispersed in both the aqueous or anhydrous states. MIC and MBC, time-killing curves, biofilm formation inhibition assay, mature biofilm disruption assay, SEM, Ca²⁺ mobilization assay and Ca²⁺-Mg²⁺-ATPase activity studies revealed that CQ@Ru-SA had a stronger inhibitory effect against S. aureus than CQ and showed sustained antibacterial properties in the dynamic time-killing curves. Meanwhile, CQ@Ru-SA had good antibacterial effects against S. aureus and inhibited their biofilm forming ability in a dose-dependent manner. Further studies on antibacterial mechanisms revealed that CQ@Ru-SA influenced cell membrane integrity, Ca²⁺-Mg²⁺-ATPase activity on the cell membrane and intracellular Ca²⁺ levels of S. aureus. This study will provide the necessary data for the further design and development of ruthenium-based photosensitive antibacterial agents.

Functionalization of Se-Te Nanorods with Au Nanoparticles for Enhanced Anti-Bacterial and Anti-Cancer Activities

The use of medical devices for therapeutic and diagnostic purpose is globally increasing; however, bacterial colonization on therapeutic devices can occur, causing severe infections in the human body. It has become an issue for public health. It is necessary to develop a nanomaterial based on photothermal treatment to kill toxic bacterial strains. Appropriately, high photothermal conversion and low-cost powerful photothermal agents have been investigated. Recently, gold nanocomposites have attracted great interest in biological applications. Here, we prepared rod-shaped Se-Te@Au nanocomposites of about 200 nm with uniform shape and surface-coated with gold nanoparticles for the first time showing high anti-bacterial and anti-cancer activities. Se-Te@Au showed proper structural consistency and natural resistance to bacterial and cancer cells. The strong absorption and high photothermal conversion efficacy made it a good photothermal agent material for the photothermal treatment of bacterial and cancer cells. The Se-Te@Au rod showed excellent anti-bacterial efficacy against Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus, with highest recorded inhibition zones of 25 ± 2 mm and 22 ± 2 mm, respectively. More than 99% of both types of strains were killed after 5 min with a near-infrared (NIR) laser at the very low concentration of 48 µg/mL. The Se-Te@Au rod’s explosion in HeLa cells was extensively repressed and demonstrated high toxicity at 100 µg/mL for 5 min when subjected to an NIR laser. As a result of its high photothermal characteristics, the exceptional anti-bacterial and anti-cancer effects of the Se-Te@Au rod are considerably better than those of other methods previously published in articles. This study could open a new framework for sterilization applications on the industrial level.

Engineered Living Hydrogels

Living biological systems, ranging from single cells to whole organisms, can sense, process information, and actuate in response to changing environmental conditions. Inspired by living biological systems, engineered living cells and nonliving matrices are brought together, which gives rise to the technology of engineered living materials. By designing the functionalities of living cells and the structures of nonliving matrices, engineered living materials can be created to detect variability in the surrounding environment and to adjust their functions accordingly, thereby enabling applications in health monitoring, disease treatment, and environmental remediation. Hydrogels, a class of soft, wet, and biocompatible materials, have been widely used as matrices for engineered living cells, leading to the nascent field of engineered living hydrogels. Here, the interactions between hydrogel matrices and engineered living cells are described, focusing on how hydrogels influence cell behaviors and how cells affect hydrogel properties. The interactions between engineered living hydrogels and their environments, and how these interactions enable versatile applications, are also discussed. Finally, current challenges facing the field of engineered living hydrogels for their applications in clinical and environmental settings are highlighted.

[Results of a clinical study of the combination of flurbiprofen and cetylpyridinium chloride in patients with sore throat]

Sore throat is one of the most frequent complaints with which patients seek medical help from an otorhinolaryngologist, therapist and pediatrician.

OBJECTIVE

To evaluate the efficacy and safety of a combined topical drug with flurbiprofen and cetylpyridinium chloride in patients with sore throat caused by upper respiratory tract infections.

MATERIAL AND METHODS

A prospective multicenter open randomized comparative study in parallel groups included 266 adult patients with an established diagnosis of acute pharyngitis or acute tonsillitis aged 18 to 60 years with the main complaint of sore throat caused by viral infections of the upper respiratory tract. The patients included in the study were randomized into two groups of 133 participants each: the 1st group included patients who received the combined agent flurbiprofen 8.75 mg and cetylpyridinium chloride 1.00 mg in the form of tablets for resorption, the 2nd group included patients who received cetylpyridinium chloride 1.2 mg in the form of medicinal lozenges. The effectiveness was evaluated on several scales (RADT, STPIS, TPA, STPR) reflecting subjective and objective indicators of the dynamics of the disease.

RESULTS

The studied combination proved to be more effective than the monocomponent agent and was characterized by a more pronounced decrease in sore throat within 2 hours after taking the drug and a decrease in pharyngeal hyperemia.

CONCLUSION

According to the results of the study, the use of a drug based on a combination of flurbiprofen and cetylpyridinium chloride was accompanied by a rapid and pronounced decrease in sore throat and pharyngeal hyperemia in patients with upper respiratory tract infections.

Chitosan-Based Biomaterial Scaffolds for the Repair of Infected Bone Defects

The treatment of infected bone defects includes infection control and repair of the bone defect. The development of biomaterials with anti-infection and osteogenic ability provides a promising strategy for the repair of infected bone defects. Owing to its antibacterial properties, chitosan (an emerging natural polymer) has been widely studied in bone tissue engineering. Moreover, it has been shown that chitosan promotes the adhesion and proliferation of osteoblast-related cells, and can serve as an ideal carrier for bone-promoting substances. In this review, the specific molecular mechanisms underlying the antibacterial effects of chitosan and its ability to promote bone repair are discussed. Furthermore, the properties of several kinds of functionalized chitosan are analyzed and compared with those of pure chitosan. The latest research on the combination of chitosan with different types of functionalized materials and biomolecules for the treatment of infected bone defects is also summarized. Finally, the current shortcomings of chitosan-based biomaterials for the treatment of infected bone defects and future research directions are discussed. This review provides a theoretical basis and advanced design strategies for the use of chitosan-based biomaterials in the treatment of infected bone defects.

Quaternized Polysaccharide-Based Cationic Micelles as a Macromolecular Approach to Eradicate Multidrug-Resistant Bacterial Infections while Mitigating Antimicrobial Resistance

Microbial infections and microbial resistance lead to a high demand for new antimicrobial agents. Quaternized polysaccharides are cationic antimicrobial candidates; however, the limitation of homogeneous synthesis solvents that affect the molecular structure and biological activities, as well as their drug resistance remains unclear. Therefore, the authors homogeneously synthesize a series of quaternized chitin (QC) and quaternized chitosan (QCS) derivatives via a green and effective KOH/urea system and investigate their structure-activity relationship and biological activity in vivo and in vitro. Their study reveals that a proper match of degree of quaternization (DQ) and degree of deacetylation (DD') of QC or QCS is key to balance antimicrobial property and cytotoxicity. They identify QCS-2 as the optimized antimicrobial agent with a DQ of 0.46 and DD' of 82%, which exhibits effective broad-spectrum antimicrobial properties, good hemocompatibility, excellent cytocompatibility, and effective inhibition of bacterial biofilm formation and eradication of mature bacterial biofilms. Moreover, QCS-2 exhibits a low propensity for development of drug resistance and significant anti-infective effects on MRSA in vivo comparable to that of vancomycin, avoiding excessive inflammation and promoting the formation of new blood vessels, hair follicles, and collagen deposition to thus expedite wound healing.

The role of aldehyde-functionalized crosslinkers on the property of chitosan hydrogels

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Antimicrobial Peptides and Macromolecules for Combating Microbial Infections: From Agents to Interfaces

Bacterial resistance caused by the overuse of antibiotics and the shelter of biofilms has evolved into a global health crisis, which drives researchers to continuously explore antimicrobial molecules and strategies to fight against drug-resistant bacteria and biofilm-associated infections. Cationic antimicrobial peptides (AMPs) are considered to be a category of potential alternative for antibiotics owing to their excellent bactericidal potency and lesser likelihood of inducing drug resistance through their distinctive antimicrobial mechanisms. In this review, the hitherto reported plentiful action modes of AMPs are systematically classified into 15 types and three categories (membrane destructive, nondestructive membrane disturbance, and intracellular targeting mechanisms). Besides natural AMPs, cationic polypeptides, synthetic polymers, and biopolymers enable to achieve tunable antimicrobial properties by optimizing their structures. Subsequently, the applications of these cationic antimicrobial agents at the biointerface as contact-active surface coatings and multifunctional wound dressings are also emphasized here. At last, we provide our perspectives on the development of clinically significant cationic antimicrobials and related challenges in the translation of these materials.

[Results of the clinical study of the combination of flurbiprofen and cetylpyridinium chloride in patients with sore throat]

Sore throat is one of the most frequent complaints with which patients seek medical help from an otorhinolaryngologist, therapist and pediatrician.

OBJECTIVE

To evaluate the efficacy and safety of a combined topical drug with flurbiprofen and cetylpyridinium chloride compared with a monocomponent drug in patients with sore throat associated with manifestations of acute pharyngitis, tonsillitis or with exacerbation of chronic forms of pharyngitis or tonsillitis.

MATERIAL AND METHODS

A prospective, multicenter, open, randomized, comparative study in parallel groups included 266 adult patients aged 18 to 60 years with an established diagnosis of acute pharyngitis or acute tonsillitis with the main complaint of sore throat caused by viral infections of the upper respiratory tract. The patients included in the study were randomized into two groups of 133 participants each: the 1st group included patients who received the combined agent flurbiprofen 8.75 mg and cetylpyridinium chloride 1.0 mg in the form of tablets for resorption; the 2nd group included patients who received cetylpyridinium chloride 1.2 mg in the form of medicinal lozenges. The effectiveness was evaluated on three scales - STPIS, TPA, STPR, reflecting indicators of the dynamics of the disease.

RESULTS

The studied combination turned out to be more effective than the monocomponent remedy and was characterized by a more pronounced decrease in the intensity of sore throat within 2 hours after taking the drug and a decrease in pharyngeal hyperemia.

CONCLUSION

According to results of the study, the use of a drug based on the combination of flurbiprofen and cetylpyridinium chloride was accompanied by a rapid and pronounced decrease in the intensity of sore throat and pharyngeal hyperemia in patients with upper respiratory tract infections.