A pharmacological and toxicological profile of silver as an antimicrobial agent in medical devices

A Novel Silver-Ruthenium-Based Antimicrobial Kills Gram-Negative Bacteria Through Oxidative Stress-Induced Macromolecular Damage

Amplified by the decline in antibiotic discovery, the rise of antibiotic resistance has become a significant global challenge in infectious disease control. Extraintestinal Escherichia coli (ExPEC), known to be the most common instigators of urinary tract infections (UTIs), represent such global threat. Novel strategies for more efficient treatments are therefore desperately needed. These include silver nanoparticles, which have been used as antimicrobial surface-coatings on catheters to eliminate biofilm-forming uropathogens and reduce the risk of nosocomial infections. AGXX® is a promising silver coating that presumably kills bacteria through the generation of reactive oxygen species (ROS) but is more potent than silver. However, neither is AGXX®'s mode of action fully understood, nor have its effects on Gram-negative bacteria or bacterial response and defense mechanisms towards AGXX® been studied in detail. Here, we report that the bactericidal effects of AGXX® are primarily based on ROS formation, as supplementation of the media with a ROS scavenger completely abolished AGXX®-induced killing. We further show that AGXX® impairs the integrity of the bacterial cell envelope and causes substantial protein aggregation and DNA damage already at sublethal concentrations. ExPEC strains appear to be more resistant to the proteotoxic effects of AGXX® compared to non-pathogenic E. coli, indicating improved defense capabilities of the uropathogen. Global transcriptomic studies of AGXX®-stressed ExPEC revealed a strong oxidative stress response, perturbations in metal homeostasis, as well as the activation of heat shock and DNA damage responses. Finally, we present evidence that ExPEC counter AGXX® damage through the production of the chaperone polyphosphate.

Biogenic silver nanoparticles incorporated hydrogel beads for anticancer and antibacterial activities

Green nanotechnology is an effective treatment approach being used in cancer research with less adverse effects. This work describes the incorporation of silver nanoparticles synthesized from clitoria ternatea plant extract (Ag@CT NPs) into sodium alginate and gelatin polymer blends (SA/GEL) to produce Ag@CT-SA/GEL polymer beads using calcium chloride (CaCl2) crosslinking agent. Both the formation and the effective incorporation of Ag@CT NPs into polymer blend have been proven by various spectroscopic analysis, surface morphology study and energy dispersive X-ray analysis. Ag@CT NPs and Ag@CT-SA/GEL demonstrate good antibacterial and antioxidant activities comparable to commercially available drug. Dimethyl thiazolyl tetrazolium bromide (MTT) anticancer assay and apoptosis study of plant extract and Ag@CT NPs against lung cancer cell lines clearly indicate that Ag@CT-SA/GEL polymer bead can serve as an effective anticancer agent.

Partial in-vitro dispersal of S. mutans UA159 biofilms by silver-(I)cyanoximate compounds

Silver(I) cyanoximate compounds have antibacterial activity against the oral pathogen Streptococcus mutans, a resident of oral plaque biofilm. As oral biofilm strategies focus on the inhibition of attachment or physical removal of the existing microbes, we were interested in exploring the ability of six different silver(I) cyanoximate compounds to target and disperse a pre-existing biofilm. Here we report that these compounds were only able to partially disperse S. mutans biofilms as the compounds were more effective at inhibiting biofilm formation. None of the six compounds were able to outperform silver nitrate, a commonly used antibacterial in dentistry.

Enhancing antibacterial properties of titanium implants through a novel Ag-TiO2-OTS nanocomposite coating: a comprehensive study on resist-killing-disintegrate approach

Titanium (Ti) implants are widely used in orthopedic and dental applications due to their excellent biocompatibility and mechanical properties. However, bacterial adhesion and subsequent biofilm formation on implant surfaces pose a significant risk of postoperative infections and complications. Conventional surface modifications often lack long-lasting antibacterial efficacy, necessitating the development of novel coatings with enhanced antimicrobial properties. This study aims to develop a novel Ag-TiO2-OTS (Silver-Titanium dioxide-Octadecyltrichlorosilane, ATO) nanocomposite coating, through a chemical plating method. By employing a 'resist-killing-disintegrate' approach, the coating is designed to inhibit bacterial adhesion effectively, and facilitate pollutant removal with lasting effects. Characterization of the coatings was performed using spectroscopy, electron microscopy, and contact angle analysis. Antibacterial efficacy, quantitatively evaluated against E. coli and S. aureus over 168 h, showed a significant reduction in bacterial adhesion by 76.6% and 66.5% respectively, and bacterial removal rates were up to 83.8% and 73.3% in comparison to uncoated Ti-base material. Additionally, antibacterial assays indicated that the ratio of the Lifshitz-van der Waals apolar component to electron donor surface energy components significantly influences bacterial adhesion and removal, underscoring a tunable parameter for optimizing antibacterial surfaces. Biocompatibility assessments with the L929 cell line revealed that the ATO coatings exhibited excellent biocompatibility, with minimal cytotoxicity and no significant impact on cell proliferation or apoptosis. The ATO coatings provided a multi-functionality surface that not only resists bacterial colonization but also possesses self-cleaning capabilities, thereby marking a substantial advancement in the development of antibacterial coatings for medical implants.

Cytotoxicity and concentration of silver ions released from dressings in the treatment of infected wounds: a systematic review

Introduction

Silver-releasing dressings are used in the treatment of infected wounds. Despite their widespread use, neither the amount of silver released nor the potential in vivo toxicity is known. The aim of this study was to evaluate the cytotoxic effects and the amount of silver released from commercially available dressings with infected wounds.

Methods

The review was conducted according to the PRISMA statement. The Web of Science, PubMed, Embase, Scopus, and CINAHL databases were searched for studies from 2002 through December 2022. The criteria were as follows: population (human patients with infected wounds); intervention (commercial dressings with clinical silver authorized for use in humans); and outcomes (concentrations of silver ions released into tissues and plasma). Any study based on silver-free dressings, experimental dressings, or dressings not for clinical use in humans should be excluded. According to the type of study, systematic reviews, experimental, quasi-experimental, and observational studies in English, Spanish, or Portuguese were considered. The quality of the selected studies was assessed using the JBI critical appraisal tools. Studies that assessed at least 65% of the included items were included. Data were extracted independently by two reviewers.

Results

740 articles were found and five were finally selected (all of them quasi-experimental). Heterogeneity was found in terms of study design, application of silver dressings, and methods of assessment, which limited the comparability between studies.

Conclusion

In vivo comparative studies of clinical dressings for control of infection lack a standardized methodology that allows observation of all the variables of silver performance at local and systemic levels, as well as evaluation of its cytotoxicity. It cannot be concluded whether the assessed concentrations of released silver in commercial dressings for the topical treatment of infected wounds are cytotoxic to skin cells.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351041, PROSPERO [CRD42022351041].

The pharmacokinetics of 38% silver diamine fluoride in healthy children with dental caries: a quasi-experimental study

PURPOSE

Silver diamine fluoride (SDF) is a medication used for the arrestment of dental caries. This study aims to determine the pharmacokinetics (PK) of silver and fluoride following SDF application in healthy children with dental caries.

METHODS

A total of 15 subjects, aged 4 to 10 years, with at least one cavity on a primary tooth, were recruited for this study. Urine samples were collected at baseline, first 24 h (F1) and second 24 h (F2) after SDF treatment for analysis of silver and fluoride content. Hair samples were also collected at baseline and at 7, 14, 30, 60, 75, and 90 days after SDF treatment to analyze silver content.

RESULTS

Participants with under or over-collection of urine, or failure to provide urine collection were excluded for fluoride analysis. As a result, eight subjects' urine samples were eligible for fluoride analysis. Significant correlations were observed between baseline urinary fluoride levels and F1/F2 levels. Pairwise comparisons from Friedman's test showed significant differences between baseline and F1 fluoride levels. For silver analysis, 15 subjects were studied. F1 urinary silver levels were higher than baseline and F2 levels. Subsequent to SDF treatment, hair silver levels displayed fluctuations around the baseline. None of the participants reported adverse effects, and all caries teeth ceased progression within 30 days.

CONCLUSIONS

The urinary fluoride levels after SDF treatment, although higher, were not clinically significant. Urinary and hair silver levels were negligible. Therefore, SDF appears safe to be used among children.

Barrier membranes for periodontal guided bone regeneration: a potential therapeutic strategy

Periodontal disease is one of the most common oral diseases with the highest incidence world-wide. In particular, the treatment of periodontal bone defects caused by periodontitis has attracted extensive attention. Guided bone regeneration (GBR) has been recognized as advanced treatment techniques for periodontal bone defects. GBR technique relies on the application of barrier membranes to protect the bone defects. The commonly used GBR membranes are resorbable and non-resorbable. Resorbable GBR membranes are divided into natural polymer resorbable membranes and synthetic polymer resorbable membranes. Each has its advantages and disadvantages. The current research focuses on exploring and improving its preparation and application. This review summarizes the recent literature on the application of GBR membranes to promote the regeneration of periodontal bone defects, elaborates on GBR development strategies, specific applications, and the progress of inducing periodontal bone regeneration to provide a theoretical basis and ideas for the future application of GBR membranes to promote the repair of periodontal bone defects.

Ag nanocomposite hydrogels with immune and regenerative microenvironment regulation promote scarless healing of infected wounds

BACKGROUND

Bacterial infection, complex wound microenvironment and persistent inflammation cause delayed wound healing and scar formation, thereby disrupting the normal function and appearance of skin tissue, which is one of the most problematic clinical issues. Although Ag NPs have a strong antibacterial effect, they tend to oxidize and form aggregates in aqueous solution, which reduces their antibacterial efficacy and increases their toxicity to tissues and organs. Current research on scar treatment is limited and mainly relies on growth factors and drugs to reduce inflammation and scar tissue formation. Therefore, there is a need to develop methods that effectively combine drug delivery, antimicrobial and anti-inflammatory agents to modulate the wound microenvironment, promote wound healing, and prevent skin scarring.

RESULTS

Herein, we developed an innovative Ag nanocomposite hydrogel (Ag NCH) by incorporating Ag nanoparticles (Ag NPs) into a matrix formed by linking catechol-modified hyaluronic acid (HA-CA) with 4-arm PEG-SH. The Ag NPs serve dual functions: they act as reservoirs for releasing Ag/Ag+ at the wound site to combat bacterial infections, and they also function as cross-linkers to ensure the sustained release of basic fibroblast growth factor (bFGF). The potent antibacterial effect of the Ag NPs embedded in the hydrogel against S.aureus was validated through comprehensive in vitro and in vivo analyses. The microstructural analysis of the hydrogels and the in vitro release studies confirmed that the Ag NCH possesses smaller pore sizes and facilitates a slower, more sustained release of bFGF. When applied to acute and infected wound sites, the Ag NCH demonstrated remarkable capabilities in reshaping the immune and regenerative microenvironment. It induced a shift from M1 to M2 macrophage polarization, down-regulated the expression of pro-inflammatory factors such as IL-6 and TNF-α, and up-regulated the expression of anti-inflammatory IL-10. Furthermore, the Ag NCH played a crucial role in regulating collagen deposition and alignment, promoting the formation of mature blood vessels, and significantly enhancing tissue reconstruction and scarless wound healing processes.

CONCLUSIONS

We think the designed Ag NCH can provide a promising therapeutic strategy for clinical applications in scarless wound healing and antibacterial therapy.

Silver nanoparticle technology in orthopaedic infections

The irrational and prolonged use of antibiotics in orthopaedic infections poses a major threat to the development of antimicrobial resistance. To combat antimicrobial resistance, researchers have implemented various novel and innovative modalities to curb infections. Nanotechnology involves doping ions/metals onto the scaffolds to reach the target site to eradicate the infective foci. In this connotation, we reviewed silver nanoparticle technology in terms of mechanism of action, clinical applications, toxicity, and regulatory guidelines to treat orthopaedic infections.

Comparative in vivo toxicokinetics of silver powder, nanosilver and soluble silver compounds after oral administration to rats

Silver (Ag; massive, powder and nanoform) and Ag compounds are used in industrial, medical and consumer applications, with potential for human exposure. Uncertainties exist about their comparative mammalian toxicokinetic ('TK') profiles, including their relative oral route bioavailability, especially for Ag massive and powder forms. This knowledge gap impedes concluding on the grouping of Ag and Ag compounds for hazard assessment purposes. Therefore, an in vivo TK study was performed in a rat model. Sprague-Dawley rats were exposed via oral gavage for up to 28 days to silver acetate (AgAc; 5, 55, 175 mg/kg(bw)/d), silver nitrate (AgNO3; 5, 55, 125 mg/kg(bw)/d), nanosilver (AgNP; 15 nm diameter; 3.6, 36, 360 mg/kg(bw)/d) or silver powder (AgMP; 0.35 µm diameter; 36, 180, 1000 mg/kg(bw)/d). Total Ag concentrations were determined in blood and tissues to provide data on comparative systemic exposure to Ag and differentials in achieved tissue Ag levels. AgAc and AgNO3 were the most bioavailable forms with comparable and linear TK profiles (achieved systemic exposures and tissue concentrations). AgMP administration led to systemic exposures of about an order of magnitude less, with tissue Ag concentrations 2-3 orders of magnitude lower and demonstrating non-linear kinetics. The apparent oral bioavailability of AgNP was intermediate between AgAc/AgNO3 and AgMP. For all test items, highest tissue Ag concentrations were in the gastrointestinal tract and reticuloendothelial organs, whereas brain and testis were minor sites of distribution. It was concluded that the oral bioavailability of AgMP was very limited. These findings provide hazard assessment context for various Ag test items and support the prediction that Ag in massive and powder forms exhibit low toxicity potential.

Presentation and Management Outcome of Childhood Scald Burns Managed With Hydrocolloid Dressings Compared With Silver Sulphadiazine Dressings

Scalds constitute the most common type of childhood burns. Given their potential for spontaneous healing, a variety of dressings are used to promote healing and prevent infection. This comparative study was carried out to document the clinical presentation of pediatric scald burns and evaluate their management outcome with hydrocolloid dressings versus silver sulphadiazine (SSD) in terms of complete healing, healing time, mean number of dressings required to achieve healing, and any need for split thickness skin grafting at three weeks. The study included all pediatric scald patients (aged ≤15 years) who presented with superficial partial-thickness and deep partial-thickness wounds during the study period. Exclusion criteria included children over the age of 15 years, facial scalds and full thickness scalds. Half of the patients were randomly assigned to the hydrocolloid group and half to the SSD group. Out of a total of 100 patients, 66% (n=66) were males whereas 34% (n=34) were females. Age ranged from 3 months to 15 years, with a mean of 2.88±2.86 years. Total body surface area (TBSA) affected ranged from 3% to 17% with a mean of 7.00±4.76%. The majority of the children (75%) were managed on an outpatient basis whereas 25% were hospitalized. Hydrocolloid dressings yielded superior results in terms of complete healing of the scalds, healing time, the mean number of dressings required to achieve healing, and less frequent need for split thickness skin grafting at three weeks. Given the observed benefits, hydrocolloid dressings should constitute the preferred choice of dressing for managing superficial and deep partial thickness scalds in the pediatric population.

Impact of the Functional Coating of Silver Nanoparticles on their In Vivo Performance and Biosafety

OBJECTIVE AND SIGNIFICANCE

Silver nanoparticles (AgNPs) have become an interesting therapeutic modality and drug delivery platform. Herein, we aimed to investigate the impact of functional coating on the in vivo performance of AgNPs as an economic and scalable method to modulate their behavior.

METHODS

AgNPs were coated with chitosan (CHI) as a model biopolymer using a one-pot reduction-based method, where CHI of two molecular weight ranges were investigated. The resultant CHI-coated AgNPs (AgNPs-CHI) were characterized using UV-VIS spectroscopy, DLS, and TEM. AgNPs were administered intravenously to rats and their biodistribution and serum levels of hepato-renal function markers were monitored 24 h later compared to plain AgNO₃ as a positive control.

RESULTS

UV-VIS spectroscopy confirmed the successful coating of AgNPs with CHI. DLS revealed the superiority of medium molecular weight CHI over its low molecular weight counterpart. AgNPs-CHI demonstrated a semi-complete clearance from the systemic circulation, a liver-dominated tissue tropism, and a limited renal exposure. On the other hand, AgNO₃ was poorly cleared from the circulation, with a relatively high renal exposure and a non-specific tissue tropism. AgNPs-CHI were well-tolerated by the liver and kidney without signs of toxicity or inflammation, in contrary with AgNO₃ which resulted in a significant elevation of Creatinine (CRE), Urea, and Total Protein (TP), suggesting a significant nephrotoxicity and inflammation.

CONCLUSIONS

Functional coating of AgNPs with CHI substantially modulated their in vivo behavior, promoting their hepatic selectivity and biotolerability, which can be invested in the development of drug delivery systems for the treatment of liver diseases.

Rapid Detection of Ag(I) via Size-Induced Photoluminescence Quenching of Biocompatible Green-Emitting, l-Tryptophan-Scaffolded Copper Nanoclusters

Atomically precise metal nanoclusters capped with small molecules like amino acids are highly favored due to their specific interactions and easy incorporation into biological systems. However, they are rarely explored due to the challenge of surface functionalization of nanoclusters with small molecules. Herein, we report the synthesis of a green-emitting (λex = 380 nm, λem = 500 nm), single-amino-acid (l-tryptophan)-scaffolded copper nanocluster (Trp-Cu NC) via a one-pot route under mild reaction conditions. The synthesized nanocluster can be used for the rapid detection of a heavy metal, silver (Ag(I)), in the nanomolar concentration range in real environmental and biological samples. The strong green photoluminescence intensity of the nanocluster quenched significantly upon the addition of Ag(I) due to the formation of bigger nanoparticles, thereby losing its energy quantization. A notable color change from light yellow to reddish-brown can also be observed in the presence of Ag(I), allowing its visual colorimetric detection. Portable paper strips fabricated with the Trp-Cu NC can be reliably used for on-site visual detection of Ag(I) in the micromolar concentration range. The Trp-Cu NC possesses excellent biocompatibility, making it a suitable nanoprobe for cell imaging; thus, it can act as an in vivo biomarker. The nanocluster showed a significant spectral overlap with anticancer drug doxorubicin and thus can be used as an effective fluorescence resonance energy transfer (FRET) pair. FRET results can reveal important information regarding the attachment of the drug to the nanocluster and hence its role as a potential drug carrier for targeted drug delivery within the human body.

Antibacterial activity and mechanism of flavonoids from Chimonanthus salicifolius S. Y. Hu. and its transcriptome analysis against Staphylococcus aureus

Introduction

Chimonanthus salicifolius S. Y. Hu. (FCS) possess many biological activities, but the antibacterial activity and underlying mechanisms of flavonoids from Chimonanthus salicifolius S. Y. Hu. (FCS) is still unknown.

Method

Maximum diameter of inhibition zone (DIZ), maximum diameter of inhibition zone (DIZ), the lowest minimum inhibition concentration (MIC), and the lowest minimum bactericide concentration (MBC) were used to detect the antibacterial activity. Meanwhile, related enzyme activities, the transcriptome analysis and quantitative RT-PCR were used to investigate the antibacterial activity mechanisms.

Results

The results showed that FCS (with a purity of 84.2 ± 2.0%) has potential effects on tested strains with the maximum diameter of inhibition zone (DIZ) was 15.93 ± 2.63 mm, the lowest minimum inhibition concentration (MIC) was 1.56 mg/ml and the lowest minimum bactericide concentration (MBC) was 6.25 mg/ml. In addition, the bacterial growth curve test, release of extracellular alkaline phosphatase (AKP), loss of intracellular components, DNA damage and transmission electron microscope (TEM) suggested that FCS could destroy the cell wall and membrane, cause the loss of intracellular substance, cause DNA damage and even lead to cell death. Moreover, the antibacterial mechanism of FCS against Staphylococcus aureus (S. aureus, Gram-positive bacteria) was further confirmed by the transcriptome analysis and quantitative RT-PCR at the molecular level for the first time. A total of 671 differentially expressed genes (DEGs) were identified after treated with FCS (1/2 MIC), with 338 and 333 genes showing up-regulation and down-regulation, respectively. The highlighted changes were those related to the biosynthesis of bacteria wall and membrane, DNA replication and repair, and energy metabolism.

Discussion

Overall, our research provides theoretical guidance for the application of FCS, which is expected to be potentially used as a natural antimicrobial agent in food safety.

Computer Simulation of the Interaction between SARS-CoV-2 Spike Protein and the Surface of Coinage Metals

A prominent feature of the SARS-CoV-2 virus is the presence of a large glycoprotein spike protruding from the virus envelope. The spike determines the interaction of the virus with the environment and the host. Here, we used an all-atom molecular dynamics simulation method to investigate the interaction of up- and down-conformations of the S1 subunit of the SARS-CoV-2 spike with the (100) surface of Au, Ag, and Cu. Our results revealed that the spike protein is adsorbed onto the surface of these metals, with Cu being the metal with the highest interaction with the spike. In our simulations, we considered the spike protein in both its up-conformation S^up (one receptor binding domain exposed) and down-conformation S^down (no exposed receptor binding domain). We found that the affinity of the metals for the up-conformation was higher than their affinity for the down-conformation. The structural changes in the spike in the up-conformation were also larger than the changes in the down-conformation. Comparing the present results for metals with those obtained in our previous MD simulations of S^up with other materials (cellulose, graphite, and human skin models), we see that Au induces the highest structural change in S^up, larger than those obtained in our previous studies.

Biological activities and antioxidant potential of different biosynthesized nanoparticles of Moringa oleifera

The science of nanotechnology is expanding daily and has the potential to benefit people. Moringa oleifera is an abundant source of phenolic compounds, which are bioactive substances. It is recognised as a necessary plant because of its medicinal potential and a wide variety of health benefits. The aim of the current study is to examine the antioxidant, antibacterial, and cytotoxicity effects of five nanoparticles (La₂O₃, CuO, Fe₂O₃, Ag, and ZnO) made using bioactive chemicals in the aqueous extract of Moringa oleifera leaves on four human cell lines (T47D, HepG2, A549, and Wi38). The UV-visible spectroscopy analysis with a surface plasmon peak in the 300-490 nm range and the value of the zeta potential of the various biosynthesized nanoparticles ranged from + 31 to + 37 mV, indicated the repulsion between the particles and the stability of the formulation nanoparticles confirmed the formation of all nanoparticles. Additionally, the DPPH method was used to assess the antioxidant activity of five distinct metal nanoparticles. The results show that this method works in parallel and is dependent on both the concentration of NPs and the incubation time. The anticancer effect of synthesized nanoparticles against four different cell lines has been tested. The cytotoxicity assay showed a dose-dependent and time-dependent effect of nanoparticles. The obtained results conclude that acceptable potency against T47D and A549 cell lines with IC₅₀ ranged from 38 to 210 μg/mL and 26 to 115 μg/mL, respectively. However, HepG2 and Wi38 cell lines showed relatively higher resistance against all tested nanoparticles when compared with Doxorubicin. Moreover, the antibacterial results revealed that silver nanoparticles exhibited the highest antibacterial activity against both Enterococcus faecalis and Staphylococcus aureus. Nanoparticles' high therapeutic activity at low concentrations opens up new avenues for the development of novel therapeutic approaches against human pathogens.

Recent Advances in Silver Nanoparticles Containing Nanofibers for Chronic Wound Management

Infections are the primary cause of death from burns and diabetic wounds. The clinical difficulty of treating wound infections with conventional antibiotics has progressively increased and reached a critical level, necessitating a paradigm change for enhanced chronic wound care. The most prevalent bacterium linked with these infections is Staphylococcus aureus, and the advent of community-associated methicillin-resistant Staphylococcus aureus has posed a substantial therapeutic challenge. Most existing wound dressings are ineffective and suffer from constraints such as insufficient antibacterial activity, toxicity, failure to supply enough moisture to the wound, and poor mechanical performance. Using ineffective wound dressings might prolong the healing process of a wound. To meet this requirement, nanoscale scaffolds with their desirable qualities, which include the potential to distribute bioactive agents, a large surface area, enhanced mechanical capabilities, the ability to imitate the extracellular matrix (ECM), and high porosity, have attracted considerable interest. The incorporation of nanoparticles into nanofiber scaffolds constitutes a novel approach to “nanoparticle dressing” that has acquired significant popularity for wound healing. Due to their remarkable antibacterial capabilities, silver nanoparticles are attractive materials for wound healing. This review focuses on the therapeutic applications of nanofiber wound dressings containing Ag-NPs and their potential to revolutionize wound healing.

Silver Nanoparticles and Its Mechanistic Insight for Chronic Wound Healing: Review on Recent Progress

Wounds are structural and functional disruptions of skin that occur because of trauma, surgery, acute illness, or chronic disease conditions. Chronic wounds are caused by a breakdown in the finely coordinated cascade of events that occurs during healing. Wound healing is a long process that split into at least three continuous and overlapping processes: an inflammatory response, a proliferative phase, and finally the tissue remodeling. Therefore, these processes are extensively studied to develop novel therapeutics in order to achieve maximum recovery with minimum scarring. Several growth hormones and cytokines secreted at the site of lesions tightly regulates the healing processes. The traditional approach for wound management has been represented by topical treatments. Metal nanoparticles (e.g., silver, gold and zinc) are increasingly being employed in dermatology due to their favorable effects on healing, as well as in treating and preventing secondary bacterial infections. In the current review, a brief introduction on traditional would healing approach is provided, followed by focus on the potential of wound dressing therapeutic techniques functionalized with Ag-NPs.

Innovative Codeposition of a Ag-Al2O3 Layer: An Attractive Combination of High Durability and Lack of Cytotoxicity for Public Space Applications

Today, the use of silver in surfaces for public environments is very frequent, as it ensures high antimicrobial activities, avoiding the continuous disinfection of the surfaces themselves. Similarly, thanks to its interesting combination of technological properties, anodized aluminum is widely employed in the production of components for applications in public spaces. Therefore, this work describes a simple method of the codeposition of silver and anodized aluminum to combine the remarkable properties of Al₂O₃ layers with the antibacterial performances of silver. The effect of silver in modifying the durability features of the anodized aluminum layer was evaluated by means of various accelerated degradation techniques, such as the exposure in a climatic chamber to UV-B radiation or an aggressive atmosphere simulated by the Kesternich test. These analyses showed the good compatibility between Ag and the alumina matrix, whose durability performances were not particularly influenced by silver. Furthermore, the composite layers did not express relevant cytotoxicity activity, as evidenced by Trypan blue flow cytometry analysis and microscopy observations, ensuring the possible use of this material in applications in close contact with humans. This same conclusion was reached by observing an almost negligible ionic release of Ag by the composite layers, even following severe degradation of the alumina matrix due to exposure to a particular acid solution. In conclusion, this work presents an innovative material that can be used in public spaces, thanks to its interesting combination of high durability and low cytotoxicity.

The Fate of Intranasally Instilled Silver Nanoarchitectures

The intranasal administration of drugs allows an effective and noninvasive therapeutic action on the respiratory tract. In an era of rapidly increasing antimicrobial resistance, new approaches to the treatment of communicable diseases, especially lung infections, are urgently needed. Metal nanoparticles are recognized as a potential last-line defense, but limited data on the biosafety and nano/biointeractions preclude their use. Here, we quantitatively and qualitatively assess the fate and the potential risks associated with the exposure to a silver nanomaterial model (i.e., silver ultrasmall-in-nano architectures, AgNAs) after a single dose instillation. Our results highlight that the biodistribution profile and the nano/biointeractions are critically influenced by both the design of the nanomaterial and the chemical nature of the metal. Overall, our data suggest that the instillation of rationally engineered nanomaterials might be exploited to develop future treatments for (non)communicable diseases of the respiratory tract.

First Report on the Phenotypic and Genotypic Susceptibility Profiles to Silver Nitrate in Bacterial Strains Isolated from Infected Leg Ulcers in Romanian Patients

Silver-ion-based antiseptics are widely used in treating chronic leg ulcers and, given the emergence of resistance to such compounds, the investigation of silver susceptibility and resistance profiles of pathogenic strains isolated from this type of wound is a topic of great interest. Therefore, in this study, 125 bacterial strains isolated from 103 patients with venous ulcers were investigated to elucidate their susceptibility to silver-nitrate solutions in planktonic and biofilm growth states, and the associated genetic determinants. The isolated strains, both in the planktonic and biofilm growth phases, showed high sensitivity to the standard concentration of 1/6000 silver-nitrate solution. It was noticed that even at concentrations lower than the clinical one (the first 2–3 binary dilutions in the case of planktonic cultures and the first 6–7 binary dilutions in the case of biofilms), the antiseptic solution proved to maintain its antibacterial activity. The phenotypic results were correlated with the genetic analysis, highlighting the presence of silver-resistance genes (sil operon) in only a few of the tested Staphylococcus sp. (especially in S. aureus) strains, Escherichia coli and Pseudomonas aeruginosa strains. These results demonstrate that despite its large use, this antiseptic remains a viable treatment alternative for the management of chronic leg wounds.

Influences of Extrusion and Silver Content on the Degradation of Mg-Ag Alloys In Vitro and In Vivo

Binary magnesium-silver (Mg-Ag) alloys were designed as antibacterial materials for biomedical implant applications. In the present study, we focused on the effects of extrusion (extrusion ratio (ER): 1, 7.1, and 72.2) and Ag content (Ag = 0, 3, and 6 wt.%) on the degradation of Mg-Ag alloys in vitro and in vivo via microstructure characterization and corrosion/degradation measurements. The results showed that the Ag promoted a galvanic reaction with the Mg matrix to accelerate degradation or formed a protective oxide mesh texture to inhibit degradation, especially in vivo. Ag might also be beneficial for product crystallization, biomineralization, and organic matter deposition. For pure Mg, extrusion produced a more refined grain and decreased the degradation rate. For the Mg-Ag alloys, a low extrusion ratio (7.1) accelerated the degradation caused by the increase in the proportion of the precipitate. This promoted the release of Mg2+ and Ag+, which led to more deposition of organic matter and calcium phosphate, but also more H2 bubbles, which led to disturbance of product deposition in some local positions or even inflammatory reactions. Extrusion at a higher ratio (72.2) dissolved the precipitates. This resulted in moderate degradation rates and less gas production, which promoted osteogenesis without an obvious inflammation reaction.

Effect of Different Forms of Silver on Biological Objects

Silver has been known since ancient times on account of its pronounced antiseptic properties. Currently, its antibacterial, antiviral, and fungicidal properties are highly desired in the food and cosmetic industries, in medicine, and pharmacology. Silver exhibits toxic effects not only on pathogenic organisms but also on healthy cells. Over the past 20 years, nanosilver, a new form of silver, has been introduced in various areas of industry. The transition to the nanoscale form results in the revision of standard approaches to items, including those based on this element, and the emergence of such a novel research area as nanosafety. In this review, we address the history of using different forms of silver, the mechanisms of its interaction with living cells, toxic properties, biokinetic parameters, capability for accumulation in different organs, effects on cognitive functions, and the clinically known argyrosis condition. Relevant publications are critically analyzed and conclusions are drawn. The broader incorporation of such a weakly biophilic element as silver in the biosphere and ecosphere calls for our understanding of biochemical processes underlying the interaction of this element, in its different forms, with living cells and multicellular organisms.

New solutions for combatting implant bacterial infection based on silver nano-dispersed and gallium incorporated phosphate bioactive glass sputtered films: A preliminary study

Ag/Ga were incorporated into resorbable orthopaedic phosphate bioactive glasses (PBG, containing P, Ca, Mg, Na, and Fe) thin films to demonstrate their potential to limit growth of Staphylococcus aureus and Escherichia coli in post-operative prosthetic implantation. Dual target consecutive co-sputtering was uniquely employed to produce a 46 nm Ag:PBG composite observed by high resolution TEM to consist of uniformly dispersed ~5 nm metallic Ag nano-particles in a glass matrix. Ga3+ was integrated into a phosphate glass preform target which was magnetron sputtered to film thicknesses of ~400 or 1400 nm. All coatings exhibited high surface energy of 75.4-77.3 mN/m, attributed to the presence of hydrolytic P-O-P structural surface bonds. Degradation profiles obtained in deionized water, nutrient broth and cell culture medium showed varying ion release profiles, whereby Ga release was measured in 1400 nm coating by ICP-MS to be ~6, 27, and 4 ppm respectively, fully dissolving by 24 h. Solubility of Ag nanoparticles was only observed in nutrient broth (~9 ppm by 24 h). Quantification of colony forming units after 24 h showed encouraging antibacterial efficacy towards both S. aureus (4-log reduction for Ag:PBG and 6-log reduction for Ga-PBG≈1400 nm) and E. coli (5-log reduction for all physical vapour deposited layers) strains. Human Hs27 fibroblast and mesenchymal stem cell line in vitro tests indicated good cytocompatibility for all sputtered layers, with a marginal cell proliferation inertia in the case of the Ag:PBG composite thin film. The study therefore highlights the (i) significant manufacturing development via the controlled inclusion of metallic nanoparticles into a PBG glass matrix by dual consecutive target co-sputtering and (ii) potential of PBG resorbable thin-film structures to incorporate and release cytocompatible/antibacterial oxides. Both architectures showed prospective bio-functional performance for a future generation of endo-osseous implant-type coatings.

Synthesis, purification and characterization of Plectonema derived AgNPs with elucidation of the role of protein in nanoparticle stabilization

Driven by the need to biosynthesize alternate biomedical agents to prevent and treat infection, silver nanoparticles have surfaced as a promising avenue. Cyanobacteria-derived nanomaterial synthesis is of substantive interest as it offers an eco-friendly, cost-effective, sustainable, and biocompatible route for further development. In the present study optimal conditions for synthesis of silver nanoparticles (AgNPs) were 1 : 9 v/v [cell extract: AgNO3 (1 mM)], pH 7.4, and 30 °C reaction temperatures. Synthesis of nanoparticles was monitored by UV-vis spectrophotometry and the maximum absorbance was observed at a wavelength of 420 nm. SEM with EDX analysis confirmed 96.85% silver by weight which revealed the purity of AgNPs. TEM & XRD analysis exhibited a particle size of ∼12 nm with crystalline nature. FTIR analysis confirmed the presence of possible biomolecules involved in the synthesis and stabilization of AgNPs. Decapping of AgNPs followed by SDS-PAGE, LCMS and MALDI TOF analysis elucidates the proteinaceous nature of the capping and stabilizing agent. Cyanobacterial-derived capped AgNPs showed more cytotoxicicity towards a non-small cell lung cancer (A549) cell line, free radical scavenger and an antimicrobial than de-capped AgNPs. In addition they showed significant synergistic characteristics with antibiotics and fungicides. The test revealed that the capped AgNPs were biocompatible with good anti-inflammatory properties. The blend of antimicrobial and biocompatible properties, coupled with their intrinsic "green" and facile synthesis, made these biogenic nanoparticles particularly attractive for future applications in nanomedicine.

Comparative Assessment of Silver Nanocomposites' Biological Effects on the Natural and Synthetic Matrix

The aim of our investigation was to make a comparative assessment of the biological effects of silver nanoparticles encapsulated in a natural and synthetic polymer matrix. We carried out a comparative assessment of the biological effect of silver nanocomposites on natural (arabinogalactan) and synthetic (poly-1-vinyl-1,2,4-triazole) matrices. We used 144 three-month-old white outbred male rats, which were divided into six groups. Substances were administered orally for 9 days at a dose 500 μg/kg. Twelve rats from each group were withdrawn from the experiment immediately after nine days of exposure (early period), and the remaining 12 rats were withdrawn from the experiment 6 months after the end of the nine-day exposure (long-term period). We investigated the parietal–temporal area of the cerebral cortex using histological (morphological assessments of nervous tissue), electron microscopic (calculation of mitochondrial areas and assessment of the quality of the cell nucleus), and immunohistochemical methods (study of the expression of proteins regulating apoptosis bcl-2 and caspase 3). We found that the effect of the nanocomposite on the arabinogalactan matrix causes a disturbance in the nervous tissue structure, an increase in the area of mitochondria, a disturbance of the structure of nerve cells, and activation of the process of apoptosis.

Electrospun Antibacterial Nanomaterials for Wound Dressings Applications

Chronic wounds are caused by bacterial infections and create major healthcare discomforts; to overcome this issue, wound dressings with antibacterial properties are to be utilized. The requirements of antibacterial wound dressings cannot be fulfilled by traditional wound dressing materials. Hence, to improve and accelerate the process of wound healing, an antibacterial wound dressing is to be designed. Electrospun nanofibers offer a promising solution to the management of wound healing, and numerous options are available to load antibacterial compounds onto the nanofiber webs. This review gives us an overview of some recent advances of electrospun antibacterial nanomaterials used in wound dressings. First, we provide a brief overview of the electrospinning process of nanofibers in wound healing and later discuss electrospun fibers that have incorporated various antimicrobial agents to be used in wound dressings. In addition, we highlight the latest research and patents related to electrospun nanofibers in wound dressing. This review also aims to concentrate on the importance of nanofibers for wound dressing applications and discuss functionalized antibacterial nanofibers in wound dressing.

Cellulose-Silver Composites Materials: Preparation and Applications

Cellulose has received great attention owing to its distinctive structural features, exciting physico-chemical properties, and varied applications. The combination of cellulose and silver nanoparticles currently allows to fabricate different promising functional nanocomposites with unique properties. The current work offers a wide and accurate overview of the preparation methods of cellulose-silver nanocomposite materials, also providing a punctual discussion of their potential applications in different fields (i.e., wound dressing, high-performance textiles, electronics, catalysis, sensing, antimicrobial filtering, and packaging). In particular, different preparation methods of cellulose/silver nanocomposites based on in situ thermal reduction, blending and dip-coating, or additive manufacturing techniques were thoroughly described. Hence, the correlations among the structure and physico-chemical properties in cellulose/silver nanocomposites were investigated in order to better control the final properties of the nanocomposites and analyze the key points and limitations of the current manufacturing approaches.

Quantification of silver in several samples using a new ionophore polymer membrane as an optical sensor

Growing concerns about the possible toxicity of silver to aquatic organisms, bacteria, and humans have led to newly issued regulations by the United States Environmental Protection Agency (US EPA) and the Food and Drug Administration (FDA) regarding the use of silver. However, the increase in bacterial resistance to antibiotics has led to a resurgence in the use of silver as a biocidal agent in applications ranging from washing machine additives to the drinking water treatment system on the International Space Station (ISS). For Ag+ ion detection, a highly sensitive and reversible optical sensor has been established. The optode relies on a novel Schiff base, namely 2-[(benzo[d]thiazol-2-ylimino)methyl]phenol (BTMP) immobilized within PVC film and also incorporated with tris(2-ethylhexyl)phosphate (TEHP) and Aliquat 336 as an ion carrier. Under optimum conditions (i.e. pH 8.5), the proposed sensor displayed a linear response to Ag+ over 4.8 × 10-9 to 1.0 × 10-5 M (0.8494-1698.7 μg L-1) with limits of detection and quantification of 1.5 × 10-9 and 4.8 × 10-9 M (0.2548 and 0.8494 μg L-1), respectively. The sensor's response time was found to be 8.0 min. The sensor was applied successfully to determine Ag+ ion in some real samples, including food, biological, water, and environmental samples.

Synthesis and Spectroscopic Investigations of Schiff Base Ligand and Its Bimetallic Ag(I) Complex as DNA and BSA Binders

Generation of well-defined potential metallotherapeutics for cancer treatment, one of the most population-threatening diseases, is challenging and an active area of modern research in view of their unique properties and thus multiple possible pathways of action in cells. Specifically, Schiff base ligands were recognized as very promising building blocks for the construction of stable and active complexes of numerous geometries and topologies. Incorporation of Ag(I) ions allows for the formation of flat complexes with potential unoccupied coordination sites, thus giving rise to specific interactions between the metallotherapeutic and biomolecule of interest. Herein, we present the design, synthesis and characterization of new Schiff base ligand L and its Ag(I) bimetallic complex [Ag2L2]2+ with two planar moieties formed around the metal ions and connected through cyclohexane rings, confirmed by X-ray measurements. The compounds were described in context of their potential use as anticancer drugs through DNA and BSA binding pathways by several spectroscopic methods (CD, UV-Vis, fluorescence). We revealed that both, L and [Ag2L2]2+, interact with similar affinity with CT-DNA (Kb~106 M-1), while they differ in the type and strength of interactions with the model albumin-BSA. [Ag2L2]2+ binds BSA in both a dynamic and static manner with the Ksv = 8.8 × 104 M-1 in the Trp-134 and Trp-213 sites, whereas L interacts with BSA only dynamically (KSV = 2.4 × 104 M-1). This found further confirmation in the CD studies which revealed a reduction in α-helix content in the albumin of 16% in presence of [Ag2L2]2+.

Recent advances in nanotherapeutics for the treatment of burn wounds

Moderate or severe burns are potentially devastating injuries that can even cause death, and many of them occur every year. Infection prevention, anti-inflammation, pain management and administration of growth factors play key roles in the treatment of burn wounds. Novel therapeutic strategies under development, such as nanotherapeutics, are promising prospects for burn wound treatment. Nanotherapeutics, including metallic and polymeric nanoformulations, have been extensively developed to manage various types of burns. Both human and animal studies have demonstrated that nanotherapeutics are biocompatible and effective in this application. Herein, we provide comprehensive knowledge of and an update on the progress of various nanoformulations for the treatment of burn wounds.

The Antimicrobial Activity of the AGXX® Surface Coating Requires a Small Particle Size to Efficiently Kill Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) isolates are often resistant to multiple antibiotics and pose a major health burden due to limited treatment options. The novel AGXX® surface coating exerts strong antimicrobial activity and successfully kills multi-resistant pathogens, including MRSA. The mode of action of AGXX® particles involves the generation of reactive oxygen species (ROS), which induce an oxidative and metal stress response, increased protein thiol-oxidations, protein aggregations, and an oxidized bacillithiol (BSH) redox state in S. aureus. In this work, we report that the AGXX® particle size determines the effective dose and time-course of S. aureus USA300JE2 killing. We found that the two charges AGXX®373 and AGXX®383 differ strongly in their effective concentrations and times required for microbial killing. While 20–40 μg/ml AGXX®373 of the smaller particle size of 1.5–2.5 μm resulted in >99.9% killing after 2 h, much higher amounts of 60–80 μg/ml AGXX®383 of the larger particle size of >3.2 μm led to a >99% killing of S. aureus USA300JE2 within 3 h. Smaller AGXX® particles have a higher surface/volume ratio and therefore higher antimicrobial activity to kill at lower concentrations in a shorter time period compared to the larger particles. Thus, in future preparations of AGXX® particles, the size of the particles should be kept at a minimum for maximal antimicrobial activity.

Incorporation of Silver Nanoparticles in Hydrogel Matrices for Controlling Wound Infection

For centuries, silver has been recognized for its antibacterial properties. With the development of nanotechnology, silver nanoparticles (AgNPs) have garnered significant attention for their diverse uses in antimicrobial gel formulations, dressings for wound healing, orthopedic applications, medical catheters and instruments, implants, and contact lens coatings. A major focus has been determining AgNPs' physical, chemical, and biological characteristics and their potential to be incorporated in biocomposite materials, particularly hydrogel scaffolds, for burn and wound healing. Though AgNPs have been rigorously explored and extensively utilized in medical and nonmedical applications, important research is still needed to elucidate their antibacterial activity when incorporated in wound-healing scaffolds. In this review, we provide an up-to-date, 10-yr (2010-2019), comprehensive literature review on advancements in the understanding of AgNP characteristics, including the particles' preparation and mechanisms of activity, and we explore various hydrogel scaffolds for delivering AgNPs.

The Antimicrobial Properties of Modified Pharmaceutical Bentonite with Zinc and Copper

Pharmaceutical grade bentonite, containing a high amount of montmorillonite, enriched with zinc (Zn) or copper (Cu) (ZnBent and CuBent, respectively) was used as the main component for the creation of formulations for cutaneous use and tested for their antimicrobial capacity. Bentonite (Bent) with added phenoxyethanol (PH) as a preservative and unmodified bentonite were used as control groups. The mineralogical composition, structural state, and physical or chemical properties, before and after the modification of the samples, were characterized utilizing X-ray Diffraction Analysis (XRD), Fourier-Transform Infrared Spectroscopy (FTIR) and X-ray Fluorescence (XRF) techniques, and Scanning Electron Microscope-Energy Dispersive Spectroscopy (SEM, SEM-EDS) analyses. In addition, the profile of zinc and copper concentration from two types of surfaces ZnBent and CuBent, and into Phosphate-Buffered Saline (PBS) are discussed. Finally, the formulations in the form of basic pastes were challenged against bacteria, molds, and yeasts, and their performance was evaluated based on the European Pharmacopeia criteria. The Cu-modified bentonite performed excellently against bacteria and yeasts, while the Zn-modified bentonite only showed great results against yeasts. Therefore, Cu-modified bentonite formulations could offer antimicrobial protection without the use of preservatives.

FRET-Based Genetically Encoded Sensor to Monitor Silver Ions

Silver is commonly used in wound dressing, photography, health care products, laboratories, pharmacy, biomedical devices, and several industrial purposes. Silver (Ag⁺) ions are more toxic pollutants widely scattered in the open environment by natural processes and dispersed in soil, air, and water bodies. Ag⁺ binds with metallothionein, macroglobulins, and albumins, which may lead to the alteration of various enzymatic metabolic pathways. To analyze the uptake and metabolism of silver ions in vitro as well as in cells, a range of high-affinity fluorescence-based nanosensors has been constructed using a periplasmic protein CusF, a part of the CusCFBA efflux complex, which is involved in providing resistance against copper and silver ions in Escherichia coli. This nanosensor was constructed by combining of two fluorescent proteins (donor and acceptor) at the N- and C-terminus of the silver-binding protein (CusF), respectively. SenSil (WT) with a binding constant (K _d) of 5.171 μM was more efficient than its mutant variants (H36D and F71W). This nanosensor allows monitoring the level of silver ions in real time in prokaryotes and eukaryotes without any disruption of cells or tissues.

Monitoring Silver(I)-Insulin Complexes with Electrospray Ionization Quadrupole Ion Trap Mass Spectrometry

Ag(I)-insulin complex formation was investigated using electrospray quadrupole ion trap mass spectrometry (ESI-QIT-MS), and Ag(I) ion binding to an insulin molecule was evaluated. The Ag(I) binding ratios were measured in the range of pH 3-8. The highest binding ratio of the Ag(I) ions was obtained at pH 7. Spectrometric titration was carried out at varied molar ratios of Ag(I) ions to insulin from 20/1 to 250/1. It was observed that four Ag(I) ions were bound effectively to an insulin molecule to form Ag(I)_1-4-insulin complexes. The formation equilibrium constants of Ag(I)_1-4-insulin complexes were calculated from the ESI-QIT-MS peak intensities. The equilibrium constants were found as K_f1 = (2.92 ± 0.18) × 10⁴ M^-1, K_f2 = (1.03 ± 0.07) × 10⁴ M^-1, K_f3 = (6.67 ± 0.46) × 10³ M^-1, and K_f4 = (2.00 ± 0.16) × 10³ M^-1. The tandem MS/MS spectroscopies were studied to evaluate the stability of the Ag(I) complexes. The different flow rates with nano-ESI were performed to determine the binding of Ag(I) ions in solution or gas phase. In conclusion, it was observed that the Ag(I) ion forms stable Ag(I)_1-4-complexes with high formation equilibrium constants.

Update on the role of antiseptics in the management of chronic wounds with critical colonisation and/or biofilm

Biofilms play a major role in delaying chronic wounds from healing. A wound infiltrated with biofilm, or "critically colonised" wound, may become clinically infected if the number of microbes exceeds a critical level. Chronic wound biofilms represent a significant treatment challenge by demonstrating recalcitrance towards antimicrobial agents. However, a "window of opportunity" may exist after wound debridement when biofilms are more susceptible to topical antiseptics. Here, we discuss the role of antiseptics in the management of chronic wounds and biofilm, focusing on povidone-iodine (PVP-I) in comparison with two commonly used antiseptics: polyhexanide (PHMB) and silver. This article is based on the literature reviewed during a focus group meeting on antiseptics in wound care and biofilm management, and on a PubMed search conducted in March 2020. Compared with PHMB and silver, PVP-I has a broader spectrum of antimicrobial activity, potent antibiofilm efficacy, no acquired bacterial resistance or cross-resistance, low cytotoxicity, good tolerability, and an ability to promote wound healing. PVP-I represents a viable therapeutic option in wound care and biofilm management, with the potential to treat biofilm-infiltrated, critically colonised wounds. We propose a practical algorithm to guide the management of chronic, non-healing wounds due to critical colonisation or biofilm, using PVP-I.

Clinical and Forensic Aspects of the Different Subtypes of Argyria

Argyria encompasses the different cosmetic alterations that can develop if enough silver particles deposit in a specific tissue, typically in the skin, ranging from localized dark-blue macules to a generalized slate-gray/bluish tinge following systemic absorption. This work aims to fully review the state of the art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic features of argyria. Argyria has been diagnosed in a wide range of ages, both sexes and varied ethnicities, with no known individual predisposing factors. Ultraviolet radiation with subsequence increases of melanin production aggravates the discoloration due to a reduction in the silver deposits. Physical examination and silver exposure in the anamnesis can be highly suggestive of the diagnosis, but a histopathological analysis with Energy-Dispersive X-ray Spectroscopy is required to unequivocally determine the discoloration etiology. Safe and effective treatment has only been accomplished with laser techniques, though only a few cases have been reported and with limited follow-up time. In conclusion, argyria typically has an occupational or iatrogenic etiology. It should be suspected when a patient presents with typical skin or eye lesions. A seemingly viable treatment modality, with laser technology, is finally within the horizon.

Silver(I)-N-heterocyclic carbene complexes challenge cancer; evaluation of their anticancer properties and in silico studies

Because of the continuous need for efficient therapeutic agents against various kinds of cancers and infectious diseases, the pharmaceutical industry has to find new candidates and strategies to develop novel and efficient drugs. They increasingly use computational tools in R&D stages for screening extensive sets of drug candidates before starting pre-clinical and clinical trials. N-Heterocyclic carbenes (NHCs) can be evaluated as good drug candidates because they offer both anti-cancer and anti-inflammatory features with their general low-toxicity profiles. To date, different kinds of NHCs (Cu, Co, Ni, Au, Ag, Ru, etc.) have been synthesized and their therapeutic uses has been shown. Here, we have reviewed the recent studies focused on Ag(I)-NHC complexes and their anti-cancer activities. Also, existing examples of the usage of density functional theory and structure-activity relationship have been evaluated.

Antibacterial Electrospun Polycaprolactone Membranes Coated with Polysaccharides and Silver Nanoparticles for Guided Bone and Tissue Regeneration

Electrospun polycaprolactone (PCL) membranes have been widely explored in the literature as a solution for several applications in tissue engineering and regenerative medicine. PCL hydrophobicity and its lack of bioactivity drastically limit its use in the medical field. To overcome these drawbacks, many promising strategies have been developed and proposed in the literature. In order to increase the bioactivity of electrospun PCL membranes designed for guided bone and tissue regeneration purposes, in the present work, the membranes were functionalized with a coating of bioactive lactose-modified chitosan (CTL). Since CTL can be used for the synthesis and stabilization of silver nanoparticles, a coating of this compound was employed here to provide antibacterial properties to the membranes. Scanning electron microscopy imaging revealed that the electrospinning process adopted here allowed us to obtain membranes with homogeneous fibers and without defects. Also, PCL membranes retained their mechanical properties after several weeks of aging in simulated body fluid, representing a valid support for cell growth and tissue development. CTL adsorption on membranes was investigated by fluorescence microscopy using fluorescein-labeled CTL, resulting in a homogeneous and slow release over time. Inductively coupled plasma-mass spectrometry was used to analyze the release of silver, which was shown to be stably bonded to the CTL coating and to be slowly released over time. The CTL coating improved MG63 osteoblast adhesion and proliferation on membranes. On the other hand, the presence of silver nanoparticles discouraged biofilm formation by Pseudomonas aeruginosa and Staphylococcus aureus without being cytotoxic. Overall, the stability and the biological and antibacterial properties make these membranes a valid and versatile material for applications in guided tissue regeneration and in other biomedical fields like wound healing.

Antibacterial Effect of Amino Acid-Silver Complex Loaded Montmorillonite Incorporated in Dental Acrylic Resin

Several dental materials contain silver for antibacterial effect, however the effect is relatively low. The reason for the lower antibacterial efficacy of silver is considered to be the fact that silver ions bind to chloride ions in saliva. To develop new effective silver antibacterial agents that can be useful in the mouth, we synthesized two novel amino acid (methionine or histidine)-silver complexes (Met or His-Ag) loaded with montmorillonite (Mont) and analyzed their antibacterial efficacy. At first the complexes were characterized using nuclear magnetic resonance (NMR), and amino acid-Ag complex-loaded Mont (amino acid-Ag-Mont) were characterized using X-ray diffraction (XRD) and scanning electron microscopy (SEM). The antibacterial efficacy of these materials in dental acrylic resin was then investigated by bacterial growth measurement using a spectrophotometer. As controls, commercially available silver-loaded zeolite and silver-zirconium phosphate were also tested. Dental acrylic resin incorporating His-Ag-Mont strongly inhibited Streptococcus mutans growth. This was explained by the fact that His-Ag complex revealed the highest amounts of silver ions in the presence of chloride. The structure of the amino acid-Ag complexes affected the silver ion presence in chloride and the antibacterial efficacy. His-Ag-Mont might be used as antibacterial agents for dental materials.

Ion-doped Brushite Cements for Bone Regeneration

Decades of research in orthopaedics has culminated in the quest for formidable yet resorbable biomaterials using bioactive materials. Brushite cements most salient features embrace high biocompatibility, bioresorbability, osteoconductivity, self-setting characteristics, handling, and injectability properties. Such type of materials is also effectively applied as drug delivery systems. However, brushite cements possess limited mechanical strength and fast setting times. By means of incorporating bioactive ions, which are incredibly promising in directing cell fate when incorporated within biomaterials, it can yield biomaterials with superior mechanical properties. Therefore, it is a key to develop fine-tuned regenerative medicine therapeutics. A comprehensive overview of the current accomplishments of ion-doped brushite cements for bone tissue repair and regeneration is provided herein. The role of ionic substitution on the cements physicochemical properties, such as structural, setting time, hydration products, injectability, mechanical behaviour and ion release is discussed. Cell-material interactions, osteogenesis, angiogenesis, and antibacterial activity of the ion-doped cements, as well as its potential use as drug delivery carriers are also presented. STATEMENT OF SIGNIFICANCE: Ion-doped brushite cements have unbolted a new era in orthopaedics with high clinical interest to restore bone defects and facilitate the healing process, owing its outstanding bioresorbability and osteoconductive/osteoinductive features. Ion incorporation expands their application by increasing the osteogenic and neovascularization potential of the materials, as well as their mechanical performance. Recent accomplishments of brushite cements incorporating bioactive ions are overviewed. Focus was placed on the role of ions on the physicochemical and biological properties of the biomaterials, namely their structure, setting time, injectability and handling, mechanical behaviour, ion release and in vivo osteogenesis, angiogenesis and vascularization. Antibacterial activity of the cements and their potential use for delivery of drugs are also highlighted herein.

Dermatologic reactions to disinfectant use during the COVID-19 pandemic

Infection preventive practice of using disinfectants against SARS-CoV-2 has become the new normal due to the COVID-19 pandemic. Although disinfectants may not be applied directly to the human body, it remains at high risk of exposure including close skin contact on disinfected surfaces or during handling. This dermal contact, on a regular basis, can induce hazardous skin reactions like irritation, inflammation, and burning in severe conditions. Disinfectants are germicide chemicals that can penetrate the skin and create skin reactions that are usually regarded as irritant and allergic contact dermatitis. More importantly, disinfectants can react with skin components (proteins and lipids) to facilitate their skin penetration and disrupt the skin barrier function. Whereas the antimicrobial actions of disinfectants are well understood, much less is known regarding their dermatologic reactions, including but not limited to irritation and hypersensitivity. We reviewed the skin reactions created by those disinfectants against SARS-CoV-2 approved by the European Chemical Agency and the US Environmental Protection Agency.

A critical review on silver nanoparticles: From synthesis and applications to its mitigation through low-cost adsorption by biochar

Silver nanoparticles are one of the most beneficial forms of heavy metals in nanotechnology applications. Due to its exceptional antimicrobial properties, low electrical and thermal resistance, and surface plasmon resonance, silver nanoparticles are used in a wide variety of products, including consumer goods, healthcare, catalysts, electronics, and analytical equipment. As the production and applications of silver nanoparticles containing products increase daily, the environmental pollution due to silver nanoparticles release is increasing and affecting especially the aqueous ecosystem. Silver nanoparticles can kill useful bacteria in soil and water, and bioaccumulate in living organisms even at low concentrations from 10^-2 to 10 μg/mL silver can show antibacterial effect. On the other hand, the maximum silver discharge limit into freshwater is 0.1 μg/L and 3.2 μg/L for Australia and the USA, respectively. To reduce its toxic consequences and meet the regulatory guidelines, it is crucial to remove silver nanoparticles from wastewater before it is discharged into other water streams. Several technologies are available to remove silver nanoparticles, but the adsorption process using low-cost adsorbents is a promising alternative to mitigate silver nanoparticle pollution in the bulk stage. As one of the low-cost adsorbents, biochar produced from the biomass waste could be a suitable adsorbent. This review focuses on collating the latest evidence on silver nanoparticle production, applications, environmental consequences, and cost-effective technological approaches for silver removal from wastewater.

Clinical Application and Efficacy of Silver Drug in Ophthalmology: A Literature Review and New Formulation of EYE Drops with Drug Silver (I) Complex of Metronidazole with Improved Dosage Form

The use of silver preparations in medicine is becoming increasingly popular. The basic aim of this evaluation was to review the literature on the clinical (in vivo) and antibacterial potential of silver preparations in ophthalmic diseases. The second goal was to summarize the results of experimental research on the use of silver preparations in ophthalmology. The third objective was to present a method for stabilizing eye drops containing silver (I) complex. Analysis of the pH stability of the silver (I) complex with metronidazole in the prepared dosage form (eye drops) was carried out. Most silver preparations are clinically used for topical application. Few experimental results indicate the usefulness of intraocular or systemic administration of silver (I) preparations as an alternative or additional therapy in infectious and angiogenic eye diseases. The development of a new formulation increases the stability of the dosage form. New forms of silver (I) products will certainly find application in the treatment of many ophthalmic diseases. One of the most important features of the silver (I) complex is its capacity to break down bacterial resistance. The new eye drops formula can significantly improve comfort of use. Due to their chemical nature, silver (I) compounds are difficult to stabilize, especially in the finished dosage form.