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Cooney AL, Loza LM, Najdawi K, Brommel CM, McCray PB, Sinn PL. High ionic strength vector formulations enhance gene transfer to airway epithelia. Nucleic Acids Res 2024:gkae640. [PMID: 39077931 DOI: 10.1093/nar/gkae640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 06/24/2024] [Accepted: 07/09/2024] [Indexed: 07/31/2024] Open
Abstract
A fundamental challenge for cystic fibrosis (CF) gene therapy is ensuring sufficient transduction of airway epithelia to achieve therapeutic correction. Hypertonic saline (HTS) is frequently administered to people with CF to enhance mucus clearance. HTS transiently disrupts epithelial cell tight junctions, but its ability to improve gene transfer has not been investigated. Here, we asked if increasing the concentration of NaCl enhances the transduction efficiency of three gene therapy vectors: adenovirus, AAV, and lentiviral vectors. Vectors formulated with 3-7% NaCl exhibited markedly increased transduction for all three platforms, leading to anion channel correction in primary cultures of human CF epithelial cells and enhanced gene transfer in mouse and pig airways in vivo. The mechanism of transduction enhancement involved tonicity but not osmolarity or pH. Formulating vectors with a high ionic strength solution is a simple strategy to greatly enhance efficacy and immediately improve preclinical or clinical applications.
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Affiliation(s)
- Ashley L Cooney
- University of Iowa, Stead Family Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Pappajohn Biomedical Institute; Iowa City, IA 52242, USA
| | - Laura Marquez Loza
- University of Iowa, Stead Family Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Pappajohn Biomedical Institute; Iowa City, IA 52242, USA
| | - Kenan Najdawi
- University of Iowa, Stead Family Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Pappajohn Biomedical Institute; Iowa City, IA 52242, USA
| | - Christian M Brommel
- University of Iowa, Stead Family Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Pappajohn Biomedical Institute; Iowa City, IA 52242, USA
| | - Paul B McCray
- University of Iowa, Stead Family Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Pappajohn Biomedical Institute; Iowa City, IA 52242, USA
- University of Iowa, Center for Gene Therapy; Iowa City, IA 52242, USA
| | - Patrick L Sinn
- University of Iowa, Stead Family Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Pappajohn Biomedical Institute; Iowa City, IA 52242, USA
- University of Iowa, Center for Gene Therapy; Iowa City, IA 52242, USA
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Lin JL, Zhang F, Li YB, Yuan SH, Wu JH, Zhang J, Zhang L, He Y, Chen J, Yin Y. Efficacy of physiological seawater nasal irrigation for the treatment of children with SARS-CoV-2 Omicron BA.2 variant infection: a randomized controlled trial. World J Pediatr 2024; 20:461-469. [PMID: 37691090 DOI: 10.1007/s12519-023-00749-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 07/14/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Saline nasal irrigation is an effective therapy for relieving common cold symptoms. This study aimed to investigate and explore the efficacy of physiological seawater nasal irrigation (PSNI) on children with mild and asymptomatic infection with Omicron. METHODS This randomized controlled trial was conducted in Shanghai, China, and 403 children with mild and asymptomatic infection with Omicron were included. These children were allocated into the PSNI group and the control group. The primary outcome was the duration of viral shedding (DVS), and the secondary outcome was the change in clinical symptoms. RESULTS The median age of all participants was 5.59 (6.26) years old. The DVS was significantly shorter in the PSNI group [2.40 (1.13)] than in the control group [3.09 (2.14)] (P = 0.014). The multivariable Cox regression model also showed that patients in the PSNI group had an increased probability of shorter DVS compared with patients in the control group [hazard ratio (HR), 1.27; 95% confidence interval (CI), 1.04-1.55; P = 0.017]. Subgroup analysis suggested that the DVS of patients without full vaccination was significantly reduced in the PSNI group. The proportions of runny nose and stuffy nose were apparently reduced in the first three days in the PSNI group or the control group, but there was no evidence showing that PSNI contributes to the benefit compared with the control group. CONCLUSION PSNI can reduce the DVS of patients with mild and asymptomatic infection with SARS-CoV-2 Omicron BA.2 variant.
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Affiliation(s)
- Ji-Lei Lin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong District, Shanghai, China
| | - Fen Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong District, Shanghai, China
| | - Yan-Bo Li
- University of British Columbia, Vancouver, Canada
| | - Shu-Hua Yuan
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong District, Shanghai, China
| | - Jin-Hong Wu
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong District, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong District, Shanghai, China
| | - Lei Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong District, Shanghai, China
| | - Yi He
- Information Technology Department, Shanghai Children's Medical Center National Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong District, Shanghai, China.
| | - Jie Chen
- Department of Otorhinolaryngology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong District, Shanghai, China.
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong District, Shanghai, China.
- Department of Respiratory Medicine, Sanya Women and Children's Hospital Affiliated to Hainan Medical College, Hainan Branch of Shanghai Children's Medical Center, Sanya, China.
- Department of Respiratory Medicine, Linyi Maternal and Child Healthcare Hospital, Linyi, China.
- Shanghai Children's Medical Center Pediatric Medical Complex (Pudong), Shanghai, China.
- Pediatric AI Clinical Application and Research Center, Shanghai Children's Medical Center, Shanghai, China.
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Cooney AL, Loza LM, Najdawi K, Brommel CM, McCray PB, Sinn PL. High ionic strength vector formulations enhance gene transfer to airway epithelia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.22.576687. [PMID: 38328187 PMCID: PMC10849541 DOI: 10.1101/2024.01.22.576687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
A fundamental challenge for cystic fibrosis (CF) gene therapy is ensuring sufficient transduction of airway epithelia to achieve therapeutic correction. Hypertonic saline (HTS) is frequently administered to people with CF to enhance mucus clearance. HTS transiently disrupts epithelial cell tight junctions, but its ability to improve gene transfer has not been investigated. Here we asked if increasing the concentration of NaCl enhances the transduction efficiency of three gene therapy vectors: adenovirus, AAV, and lentiviral vectors. Vectors formulated with 3-7% NaCl exhibited markedly increased transduction for all three platforms, leading to anion channel correction in primary cultures of human CF epithelial cells and enhanced gene transfer in mouse and pig airways in vivo. The mechanism of transduction enhancement involved tonicity but not osmolarity or pH. Formulating vectors with a high ionic strength solution is a simple strategy to greatly enhance efficacy and immediately improve preclinical or clinical applications.
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Affiliation(s)
- Ashley L. Cooney
- University of Iowa, Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Center for Cystic Fibrosis Gene Therapy; Iowa City, IA 52242, USA
| | - Laura Marquez Loza
- University of Iowa, Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Center for Cystic Fibrosis Gene Therapy; Iowa City, IA 52242, USA
| | - Kenan Najdawi
- University of Iowa, Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Center for Cystic Fibrosis Gene Therapy; Iowa City, IA 52242, USA
| | - Christian M. Brommel
- University of Iowa, Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Center for Cystic Fibrosis Gene Therapy; Iowa City, IA 52242, USA
| | - Paul B. McCray
- University of Iowa, Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Center for Cystic Fibrosis Gene Therapy; Iowa City, IA 52242, USA
- University of Iowa, Department of Microbiology and Immunology, Iowa City, IA 52242, USA
| | - Patrick L. Sinn
- University of Iowa, Department of Pediatrics; Iowa City, IA 52242, USA
- University of Iowa, Center for Cystic Fibrosis Gene Therapy; Iowa City, IA 52242, USA
- University of Iowa, Department of Microbiology and Immunology, Iowa City, IA 52242, USA
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Tanni S, Wehrmeister F, Prudente R, Damatto F, Breda Neto C, Oliveira L, Pagan L, Gatto M, Vieira L, Coelho L, Rezende D, Machado L, Mota G, Gaiato M, Santaella F, Campos E, Franco E, Callegari M, Okoshi MP, Weinreich U. Efficacy of BREATHOX ® Device Inhalation on Acute Symptoms Associated with COVID-19 (BREATH Study): A Randomized Pilot Clinical Trial. J Clin Med 2023; 12:6075. [PMID: 37763015 PMCID: PMC10531785 DOI: 10.3390/jcm12186075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: A high concentration of sodium chloride on in vitro cell culture leads to reduced SARS-CoV-2 replication. Therefore, our aim was to evaluate the effects of inhaling hypertonic NaCl particles (BREATHOX®) on the duration of COVID-19-induced acute symptoms. (2) Methods: A prospective, open label, randomized, standard of care-controlled group (SOC) pilot trial compared inhaled oral and nasal administered BREATHOX® (2.0 mg NaCl, particles size between 1-10 μm), with five or ten inhalations per day for ten days. The primary endpoint was the time to resolve COVID-19-related symptoms. Safety outcomes included adverse clinical and laboratory events. (3) Results: A total of 101 individuals were screened and 98 were randomly assigned to BREATHOX® ten sessions per day (Group 1; 33 patients), BREATHOX® five sessions per day (Group 2; 32 patients), or SOC (33 patients), and followed up for 28 days. There was an association with cough frequency after 10 days BREATHOX® compared to SOC [Group 1: hazard ratio (HR) 2.01, 95% confidence interval (CI) 1.06-3.81; Group 2: HR 2.17, 95% CI 1.17-4.04]. No differences between the groups for the reported symptoms' resolution time were seen after 28 days. After combining both BREATHOX® groups, the period to cough resolution 10 days after randomization was significantly lower than in SOC (HR 2.10, 95% CI 1.20-3.67). An adverse event occurred in 30% of Group 1, 36% of Group 2, and 9% in SOC individuals. One patient from SOC had a serious adverse event. Nasal burning, sore or itchy nose, and dry mouth were considered related to BREATHOX® use and resolved after stopping inhalations. (4) Conclusion: BREATHOX® inhalation is safe and may be effective in reducing the duration of COVID-19-induced coughing.
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Affiliation(s)
- Suzana Tanni
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Fernando Wehrmeister
- Departament of Social Medicine, The Faculty of Medicine, Federal University of Pelotas, Avenida Duque de Caxias 250, Pelotas 96030-002, Rio Grande do Sul, Brazil;
| | - Robson Prudente
- Clinical Hospital of Botucatu Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil;
| | - Felipe Damatto
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Carlos Breda Neto
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Leiliane Oliveira
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Luana Pagan
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Mariana Gatto
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Letícia Vieira
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Liana Coelho
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Diane Rezende
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Luiz Machado
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Gustavo Mota
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Marina Gaiato
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Felipe Santaella
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Elisângela Campos
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Estefânia Franco
- Clinical Hospital of Botucatu Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil;
| | - Matheus Callegari
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Marina Politi Okoshi
- Medical School, São Paulo State University (Unesp), Distrito de Rubião Junior s/n, Botucatu 18618-970, São Paulo, Brazil; (S.T.); (F.D.); (C.B.N.); (L.O.); (L.P.); (M.G.); (L.V.); (L.C.); (D.R.); (L.M.); (G.M.); (M.G.); (F.S.); (E.C.); (M.C.); (M.P.O.)
| | - Ulla Weinreich
- Department of Clinical Medicine, The Faculty of Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark;
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Pantazopoulos I, Chalkias A, Miziou A, Spanos M, Gerovasileiou E, Rouka E, Gourgoulianis K. A Hypertonic Seawater Nasal Irrigation Solution Containing Algal and Herbal Natural Ingredients Reduces Viral Load and SARS-CoV-2 Detection Time in the Nasal Cavity. J Pers Med 2023; 13:1093. [PMID: 37511706 PMCID: PMC10381905 DOI: 10.3390/jpm13071093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Nasal irrigation is thought to decrease the viral load present in the nasal cavity. Our aim was to assess the effect of a hypertonic seawater solution [with algal and herbal natural ingredients (Sinomarin®)] on the viral load of nasopharynx in patients hospitalized with severe COVID-19 pneumonia. We conducted a prospective, randomized, controlled trial from June 2022 to December 2022. We allocated 56 patients with COVID-19 pneumonia into two groups (28 in each group)-the hypertonic seawater group [nasal irrigations with a hypertonic seawater solution (Sinomarin®) every 4 h for 16 h per day, for two consecutive days] and the control group (no nasal irrigations). A second nasopharyngeal swab was collected 48 h after the baseline nasopharyngeal swab (8 h after the last wash in the hypertonic seawater group) to estimate the SARS-CoV-2 viral load as determined by cycle threshold (Ct) values. In the hypertonic seawater group, the mean Ct values significantly increased two days after the initial measurement [ΔCt 48-0 h = 3.86 ± 3.03 cycles, p < 0.001 (95%CI: 2.69 to 5.04)]. No significant differences in the Ct values were observed in the control group [ΔCt 48-0 h = -0.14 ± 4.29, p = 0.866 (95%CI: -1.80 to -1.52)]. At follow-up, 17 patients from the hypertonic seawater group had negative test results compared to only 9 patients from the control group (p = 0.03). Nasal irrigations with a hypertonic seawater solution containing algal and herbal natural ingredients significantly decreased nasopharyngeal viral load and the detection time of SARS-CoV-2 in the nasal cavity.
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Affiliation(s)
- Ioannis Pantazopoulos
- Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
| | - Athanasios Chalkias
- Department of Anaesthesiology, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Outcomes Research Consortium, Cleveland, OH 44195, USA
| | - Angeliki Miziou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
| | - Michalis Spanos
- Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
| | - Efrosyni Gerovasileiou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
| | - Erasmia Rouka
- Faculty of Nursing, University of Thessaly, 45550 Larissa, Greece
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Gsell M, Bulliard X, Schorderet Weber S, Xiang Y, Constant S, Steiner S, Biselli S, Pugin R, Palmieri M, Hogg A, Peitsch MC, Hoeng J, Stan A. Inactivation of SARS-CoV-2 on salt-coated surfaces: an in vitro study. Arch Microbiol 2023; 205:272. [PMID: 37391548 DOI: 10.1007/s00203-023-03614-9] [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: 11/28/2022] [Revised: 04/28/2023] [Accepted: 06/23/2023] [Indexed: 07/02/2023]
Abstract
In the COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), face masks have become a very important safety measure against the main route of transmission of the virus: droplets and aerosols. Concerns that masks contaminated with SARS-CoV-2 infectious particles could be a risk for self-contamination have emerged early in the pandemic as well as solutions to mitigate this risk. The coating of masks with sodium chloride, an antiviral and non-hazardous to health chemical, could be an option for reusable masks. To assess the antiviral properties of salt coatings deposited onto common fabrics by spraying and dipping, the present study established an in vitro bioassay using three-dimensional airway epithelial cell cultures and SARS-CoV-2 virus. Virus particles were given directly on salt-coated material, collected, and added to the cell cultures. Infectious virus particles were measured by plaque forming unit assay and in parallel viral genome copies were quantified over time. Relative to noncoated material, the sodium chloride coating significantly reduced virus replication, confirming the effectiveness of the method to prevent fomite contamination with SARS-CoV-2. In addition, the lung epithelia bioassay proved to be suitable for future evaluation of novel antiviral coatings.
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Affiliation(s)
- Monika Gsell
- Institute for Infectious Diseases, University of Berne, 3010, Bern, Switzerland.
- Swiss Institute for Translational and Entrepreneurial Medicine, 3010, Berne, Switzerland.
| | - Xavier Bulliard
- Centre Suisse d'Electronique et de Microtechnique SA (CSEM), Rue Jaquet-Droz 1, 2002, Neuchâtel, Switzerland
| | | | - Yang Xiang
- PMI R&D, Philip Morris Products S.A., Quai Jeanreaud 5, 2000, Neuchâtel, Switzerland
| | - Samuel Constant
- Epithelix Sàrl, Chemmin des Aulx 18, Plan-Les-Ouates, 1228, Geneva, Switzerland
| | - Sandro Steiner
- PMI R&D, Philip Morris Products S.A., Quai Jeanreaud 5, 2000, Neuchâtel, Switzerland
| | - Silvia Biselli
- Centre Suisse d'Electronique et de Microtechnique SA (CSEM), Rue Jaquet-Droz 1, 2002, Neuchâtel, Switzerland
| | - Raphael Pugin
- Centre Suisse d'Electronique et de Microtechnique SA (CSEM), Rue Jaquet-Droz 1, 2002, Neuchâtel, Switzerland
| | - Michele Palmieri
- Centre Suisse d'Electronique et de Microtechnique SA (CSEM), Rue Jaquet-Droz 1, 2002, Neuchâtel, Switzerland
| | - Andreas Hogg
- Coat-X SA, Eplatures-Grise 17, 2900, La Chaux-de-Fonds, Switzerland
| | - Manuel C Peitsch
- PMI R&D, Philip Morris Products S.A., Quai Jeanreaud 5, 2000, Neuchâtel, Switzerland
| | - Julia Hoeng
- PMI R&D, Philip Morris Products S.A., Quai Jeanreaud 5, 2000, Neuchâtel, Switzerland
| | - Adrian Stan
- PMI R&D, Philip Morris Products S.A., Quai Jeanreaud 5, 2000, Neuchâtel, Switzerland
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Huijghebaert S, Parviz S, Rabago D, Baxter A, Chatterjee U, Khan FR, Fabbris C, Poulas K, Hsu S. Saline nasal irrigation and gargling in COVID-19: a multidisciplinary review of effects on viral load, mucosal dynamics, and patient outcomes. Front Public Health 2023; 11:1161881. [PMID: 37397736 PMCID: PMC10312243 DOI: 10.3389/fpubh.2023.1161881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/18/2023] [Indexed: 07/04/2023] Open
Abstract
With unrelenting SARS-CoV-2 variants, additional COVID-19 mitigation strategies are needed. Oral and nasal saline irrigation (SI) is a traditional approach for respiratory infections/diseases. As a multidisciplinary network with expertise/experience with saline, we conducted a narrative review to examine mechanisms of action and clinical outcomes associated with nasal SI, gargling, spray, or nebulization in COVID-19. SI was found to reduce SARS-CoV-2 nasopharyngeal loads and hasten viral clearance. Other mechanisms may involve inhibition of viral replication, bioaerosol reduction, improved mucociliary clearance, modulation of ENaC, and neutrophil responses. Prophylaxis was documented adjunctive to personal protective equipment. COVID-19 patients experienced significant symptom relief, while overall data suggest lower hospitalization risk. We found no harm and hence recommend SI use, as safe, inexpensive, and easy-to-use hygiene measure, complementary to hand washing or mask-wearing. In view of mainly small studies, large well-controlled or surveillance studies can help to further validate the outcomes and to implement its use.
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Affiliation(s)
| | - Shehzad Parviz
- Medstar Health, Brooke Grove Rehabilitation Village, Sandy Spring, MD, United States
- Infectious Disease, Adventist Healthcare, White Oak Medical Center, Silver Spring, MD, United States
| | - David Rabago
- Departments of Family and Community Medicine and Public Health Sciences, Penn State College of Medicine, Pennsylvania, PA, United States
| | - Amy Baxter
- Department of Emergency Medicine, Augusta University, Augusta, GA, United States
| | - Uday Chatterjee
- Department of Paediatric Surgery, Park Medical Research and Welfare Society, Kolkata, West Bengal, India
| | - Farhan R. Khan
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | | | | | - Stephen Hsu
- Department of Oral Biology, Augusta University, Augusta, GA, United States
- Department of Oral Health and Diagnostic Sciences, Augusta University, Augusta, GA, United States
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8
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Supporting the Aspecific Physiological Defenses of Upper Airways against Emerging SARS-CoV-2 Variants. Pathogens 2023; 12:pathogens12020211. [PMID: 36839483 PMCID: PMC9964793 DOI: 10.3390/pathogens12020211] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 02/03/2023] Open
Abstract
The rapid rollout of COVID-19 vaccines in 2021 sparked general optimism toward controlling the severe form of the disease, preventing hospitalizations and COVID-19-associated mortality, and the transmissibility of SARS-CoV-2 infection [...].
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9
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Early Negativization of SARS-CoV-2 Infection by Nasal Spray of Seawater plus Additives: The RENAISSANCE Open-Label Controlled Clinical Trial. Pharmaceutics 2022; 14:pharmaceutics14112502. [PMID: 36432693 PMCID: PMC9696981 DOI: 10.3390/pharmaceutics14112502] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background: COVID-19 is an asymptomatic condition in 40% of cases, and most symptomatic patients present with mild/moderate disease not requiring hospitalization or intensive care, especially during the Omicron wave, when the hospitalization rate was estimated to be 0.3%. The main port of entry for SARS-CoV-2 in the human body is the nasal cavity and the upper respiratory tract is affected since the early stages of the infection. Nasal irrigation or aerosol by isotonic or hypertonic saline solution is a traditional therapeutic approach for respiratory or nasal inflammation, also featured by prophylactic properties against upper respiratory infections. Methods: We conducted a prospective open-label controlled study to assess the superiority of an already existing medication (Tonimer Lab Panthexyl 800)-a sterile hypertonic solution containing seawater, xylitol, panthenol and lactic acid-to reduce the viral shedding time in patients affected by asymptomatic or mild COVID-19. COVID-19 patients (N = 108) were split into two groups: a treatment arm (50 participants receiving standard of care plus nasal spray 3 times/day with Tonimer Lab Panthexyl 800) and a control arm (58 participants receiving standard of care but nasal spray with Tonimer Lab Panthexyl 800). The two groups, both testing initially positive for SARS-CoV-2 at real-time PCR (RT-PCR) on nasal swab, were followed up over time to assess the daily number of positive swab tests turning negative (study endpoint). Treatment effectiveness at various time lags since the first positive RT-PCR swab test was measured by rate of events in the experimental arm (EER) and in the control arm (CER), absolute risk increase (ARI) = (EER - CER), and number needed to treat (NNT) = (1/ARI). To investigate the endpoint, we used logistic and Cox regression models, expressing the result as odds ratio (OR) and hazard ratio (HR) with 95% confidence interval (95%CI), respectively. The symptoms recorded with a modified COVID-Q questionnaire at both diagnosis and first negative antigenic swab test were compared in each group (treated versus controls) by exact symmetry test. Results: During the first five days of treatment, COVID-19 patients treated with Tonimer Lab Panthexyl 800 were more likely to become negative two days before controls. According to NNT, four subjects had to be treated for five days to achieve the study endpoint in one individual. The negativization rate in patients treated with Tonimer Lab Panthexyl 800 was significantly higher than patients' treated with standard of care alone (OR = 7.39, 95%CI: 1.83-29.8; HR = 6.12, 95%CI: 1.76-21.32). There was no evidence of side effects. Conclusions: Nasal spray with Tonimer Lab Panthexyl 800 was effective against SARS-CoV-2, stopping viral shedding in the treatment arm two days before the control group. This treatment should be continued for at least five days after the first positive swab test for SARS-CoV-2.
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10
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Schorderet Weber S, Bulliard X, Bonfante R, Xiang Y, Biselli S, Steiner S, Constant S, Pugin R, Laurent A, Majeed S, Lebrun S, Palmieri M, Hogg A, Kuczaj A, Peitsch MC, Hoeng J, Stan A. In vitro testing of salt coating of fabrics as a potential antiviral agent in reusable face masks. Sci Rep 2022; 12:17041. [PMID: 36220878 PMCID: PMC9552714 DOI: 10.1038/s41598-022-21442-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/27/2022] [Indexed: 12/29/2022] Open
Abstract
During the coronavirus disease (COVID-19) pandemic, wearing face masks in public spaces became mandatory in most countries. The risk of self-contamination when handling face masks, which was one of the earliest concerns, can be mitigated by adding antiviral coatings to the masks. In the present study, we evaluated the antiviral effectiveness of sodium chloride deposited on a fabric suitable for the manufacturing of reusable cloth masks using techniques adapted to the home environment. We tested eight coating conditions, involving both spraying and dipping methods and three salt dilutions. Influenza A H3N2 virus particles were incubated directly on the salt-coated materials, collected, and added to human 3D airway epithelial cultures. Live virus replication in the epithelia was quantified over time in collected apical washes. Relative to the non-coated material, salt deposits at or above 4.3 mg/cm2 markedly reduced viral replication. However, even for larger quantities of salt, the effectiveness of the coating remained dependent on the crystal size and distribution, which in turn depended on the coating technique. These findings confirm the suitability of salt coating as antiviral protection on cloth masks, but also emphasize that particular attention should be paid to the coating protocol when developing consumer solutions.
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Affiliation(s)
| | - Xavier Bulliard
- Centre Suisse d'Electronique et de Microtechnique SA (CSEM), Rue Jaquet-Droz 1, 2002, Neuchâtel, Switzerland
| | - Rosy Bonfante
- Epithelix Sàrl, Chemin des Aulx 18, 1228, Plan-les-Ouates, Geneva, Switzerland
| | - Yang Xiang
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Silvia Biselli
- Centre Suisse d'Electronique et de Microtechnique SA (CSEM), Rue Jaquet-Droz 1, 2002, Neuchâtel, Switzerland
| | - Sandro Steiner
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Samuel Constant
- Epithelix Sàrl, Chemin des Aulx 18, 1228, Plan-les-Ouates, Geneva, Switzerland
| | - Raphael Pugin
- Centre Suisse d'Electronique et de Microtechnique SA (CSEM), Rue Jaquet-Droz 1, 2002, Neuchâtel, Switzerland
| | - Alexandra Laurent
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Shoaib Majeed
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Stefan Lebrun
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Michele Palmieri
- Centre Suisse d'Electronique et de Microtechnique SA (CSEM), Rue Jaquet-Droz 1, 2002, Neuchâtel, Switzerland
| | - Andreas Hogg
- Coat-X SA, Eplatures-Grise 17, 2300, La Chaux-de-Fonds, Switzerland
| | - Arkadiusz Kuczaj
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Manuel C Peitsch
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Julia Hoeng
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Adrian Stan
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
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11
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Nasopharyngeal Wash with Normal Saline Decreases SARS-CoV-2 Viral Load: A Randomized Pilot Controlled Trial. Can Respir J 2022; 2022:8794127. [PMID: 36247079 PMCID: PMC9556252 DOI: 10.1155/2022/8794127] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/21/2022] [Accepted: 09/08/2022] [Indexed: 12/24/2022] Open
Abstract
Background Although great progress has been made over the past 2 years in the scientific understanding of the biology, epidemiology, and pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), case morbidity and fatality rates remain a great concern and continue to challenge the healthcare resources worldwide as novel variants emerge. There is therefore an urgent need for affordable and readily available strategies to reduce viral transmission. Previous studies in non-COVID-19 patients have demonstrated that administration of low-salt (isotonic but 0.0375% Na) and isotonic saline (0.9% Na) solutions has been associated with an immediate, significant reduction in the microbial antigens and a related decline of microbial burden. The aim of the present study was to determine the effect of nasal washes with normal saline 0.9% on nasopharyngeal viral load and outcome in hospitalized patients with COVID-19 pneumonia. Methods We performed a prospective, randomized, pilot, controlled trial in 50 patients with confirmed COVID-19 disease. Patients were randomized into two groups, the normal saline group (received normal saline 0.9% solution for nasopharyngeal wash) and the control group (no treatment). In the normal saline group, nasopharyngeal wash was performed every 4 hours for a 16-hour period. Twenty-four hours after the baseline nasopharyngeal swab (and 8 hours after the last wash in the normal saline group), a second nasopharyngeal swab was collected for the semiquantitative estimation of the SARS-CoV-2 viral load as determined by cycle threshold (Ct) values. Results In the normal saline group, mean N gene Ct values increased significantly 24 hours after the baseline measurement [ΔCtday2−day1 = 1.87 ± 3.11 cycles, p = 0.007 (95% CI: 0.55 to 3.18)], indicating a decline in SARS-CoV-2 nasopharyngeal viral load by 8.9%. A significant decrease in mean N gene Ct values was observed in the control group, indicating an increase in viral load [ΔCtday2-day1 = −2.12 ± 2.66, p < 0.001 (95% CI: −3.20 to −1.05)] by 9.7%. The difference between the two groups 24 hours after admission and nasopharyngeal wash was 3.09 cycles (p = 0.005, 95% CI: 0.97 to 5.20). Conclusion Nasal washes with normal saline effectively decreased the viral load during hospitalization and at follow-up.
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12
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Loh D, Reiter RJ. Melatonin: Regulation of Viral Phase Separation and Epitranscriptomics in Post-Acute Sequelae of COVID-19. Int J Mol Sci 2022; 23:8122. [PMID: 35897696 PMCID: PMC9368024 DOI: 10.3390/ijms23158122] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/09/2022] [Accepted: 07/20/2022] [Indexed: 01/27/2023] Open
Abstract
The relentless, protracted evolution of the SARS-CoV-2 virus imposes tremendous pressure on herd immunity and demands versatile adaptations by the human host genome to counter transcriptomic and epitranscriptomic alterations associated with a wide range of short- and long-term manifestations during acute infection and post-acute recovery, respectively. To promote viral replication during active infection and viral persistence, the SARS-CoV-2 envelope protein regulates host cell microenvironment including pH and ion concentrations to maintain a high oxidative environment that supports template switching, causing extensive mitochondrial damage and activation of pro-inflammatory cytokine signaling cascades. Oxidative stress and mitochondrial distress induce dynamic changes to both the host and viral RNA m6A methylome, and can trigger the derepression of long interspersed nuclear element 1 (LINE1), resulting in global hypomethylation, epigenetic changes, and genomic instability. The timely application of melatonin during early infection enhances host innate antiviral immune responses by preventing the formation of "viral factories" by nucleocapsid liquid-liquid phase separation that effectively blockades viral genome transcription and packaging, the disassembly of stress granules, and the sequestration of DEAD-box RNA helicases, including DDX3X, vital to immune signaling. Melatonin prevents membrane depolarization and protects cristae morphology to suppress glycolysis via antioxidant-dependent and -independent mechanisms. By restraining the derepression of LINE1 via multifaceted strategies, and maintaining the balance in m6A RNA modifications, melatonin could be the quintessential ancient molecule that significantly influences the outcome of the constant struggle between virus and host to gain transcriptomic and epitranscriptomic dominance over the host genome during acute infection and PASC.
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Affiliation(s)
- Doris Loh
- Independent Researcher, Marble Falls, TX 78654, USA;
| | - Russel J. Reiter
- Department of Cell Systems and Anatomy, UT Health San Antonio, San Antonio, TX 78229, USA
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13
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Gennari-Felipe M, Borges L, Dermargos A, Weimann E, Curi R, Pithon-Curi TC, Hatanaka E. Hypertonic Solution in Severe COVID-19 Patient: A Potential Adjuvant Therapy. Front Med (Lausanne) 2022; 9:917008. [PMID: 35801207 PMCID: PMC9253300 DOI: 10.3389/fmed.2022.917008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) features hyper-inflammation, cytokine storm, neutrophil function changes, and sodium chloride (NaCl) homeostasis disruption, while the treatment with NaCl hypertonic solutions (HS) controls electrolytic body homeostasis and cell functions. HS treatment is a simple, popular, economic, and feasible therapy to regulate leukocyte function with a robust anti-inflammatory effect in many inflammatory diseases. The purpose of this narrative review is to highlight the knowledge on the use of HS approaches against viral infection over the past years and to describe the mechanisms involved in the release of neutrophil extracellular traps (NETs) and production of cytokine in severe lung diseases, such as COVID-19. We reported the consequences of hyponatremia in COVID-19 patients, and the immunomodulatory effects of HS, either in vitro or in vivo. We also described the relationship between electrolyte disturbances and COVID-19 infection. Although there is still a lack of clinical trials, hypertonic NaCl solutions have marked effects on neutrophil function and NETs formation, emerging as a promising adjuvant therapy in COVID-19.
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Affiliation(s)
- Matheus Gennari-Felipe
- Instituto de Ciências da Atividade Física e Esportes, Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Leandro Borges
- Instituto de Ciências da Atividade Física e Esportes, Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Alexandre Dermargos
- Instituto de Ciências da Atividade Física e Esportes, Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Eleine Weimann
- Instituto de Ciências da Atividade Física e Esportes, Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Rui Curi
- Instituto de Ciências da Atividade Física e Esportes, Universidade Cruzeiro do Sul, São Paulo, Brazil
- Seção de Produção de Imunobiológicos, Centro Bioindustrial, Instituto Butantan, São Paulo, Brazil
| | | | - Elaine Hatanaka
- Instituto de Ciências da Atividade Física e Esportes, Universidade Cruzeiro do Sul, São Paulo, Brazil
- *Correspondence: Elaine Hatanaka,
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14
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Panta P, Baruah B, Patil S. Hypertonic Saline Use and Traditional Nasal Irrigation: A Possible Preventative Measure against COVID-19. J Contemp Dent Pract 2022; 23:379-382. [PMID: 35945828 DOI: 10.5005/jp-journals-10024-3278] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Saline nasal irrigation (SNI) is a clinically established treatment that has been used to manage upper respiratory infections and allergies; there is also some indication that it may be effective in the setting of coronavirus disease-2019 (COVID-19). The possible advantages of SNI include the following benefits due to the well-known antiviral impact of sodium chloride (NaCl) and the mechanical cleansing effect arising from the irrigation method. First, there will most likely be a decrease in COVID-19 infection rates; second, illness severity will be lowered; and third, community transmission will be mitigated. Despite the need for more concentrated research into these aspects, public health organizations should emphasize alternate infection mitigation measures such as SNI in light of the ongoing COVID-19 problem, low global vaccine supply, and the rapid introduction of SARS-CoV-2 variants. Keywords: Community transmission, COVID-19, Pandemic, Prevention, Saline, SARS-CoV-2.
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Affiliation(s)
- Prashanth Panta
- Department of Oral Medicine and Radiology, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India, Phone: +91 9701806830, e-mail:
| | - Bharat Baruah
- Department of Chemistry and Biochemistry, Kennesaw State University, Kennesaw, Georgia, United States of America
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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