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Amorim AS, Arnaut ZA, Mata AI, Pucelik B, Barzowska A, da Silva GJ, Pereira MM, Dąbrowski JM, Arnaut LG. Efficient and Selective, In Vitro and In Vivo, Antimicrobial Photodynamic Therapy with a Dicationic Chlorin in Combination with KI. ACS Infect Dis 2024. [PMID: 39150769 DOI: 10.1021/acsinfecdis.4c00492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2024]
Abstract
Various cationic photosensitizers employed in antimicrobial photodynamic therapy (aPDT) have the ability to photoinactivate planktonic bacteria under conditions of low phototoxicity to mammalian cells and without generating antimicrobial resistance (AMR). However, the photoinactivation of biofilms requires orders-of-magnitude higher photosensitizer concentrations, which become toxic to host cells. Remarkably, the bactericidal effect of a dicationic di-imidazolyl chlorin toward planktonic S. aureus and E. coli was observed in this work for concentrations below 400 nM under illumination at 660 nm and below 50 μM for the corresponding biofilms. At the latter concentrations, the chlorin is phototoxic toward human keratinocyte cells. However, in the presence of 50 mM KI, bactericidal concentrations are reduced to less than 50 nM for planktonic bacteria and to less than 1 μM for biofilms. It is shown that the potentiation with KI involves the triiodide anion. This potentiation elicits a bactericidal effect without appreciable cytotoxicity to keratinocytes. It becomes possible to selectively inactivate biofilms with aPDT. An exploratory study treating mice with wounds infected with E. coli expressing GFP with 20 μM chlorin and 120 J cm-2 at 652 nm confirmed the potential of this chlorin to control localized infections.
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Affiliation(s)
- Anita S Amorim
- CQC-IMS, Chemistry Department, University of Coimbra, Coimbra 3004-535, Portugal
| | - Zoe A Arnaut
- CQC-IMS, Chemistry Department, University of Coimbra, Coimbra 3004-535, Portugal
| | - Ana I Mata
- CQC-IMS, Chemistry Department, University of Coimbra, Coimbra 3004-535, Portugal
| | - Barbara Pucelik
- Łukasiewicz Research Network - Kraków Institute of Technology, Kraków 30-418, Poland
| | - Agata Barzowska
- Łukasiewicz Research Network - Kraków Institute of Technology, Kraków 30-418, Poland
| | - Gabriela J da Silva
- Faculty of Pharmacy of the University of Coimbra and Center for Neurosciences and Cell Biology, Coimbra 3000-548, Portugal
| | - Mariette M Pereira
- CQC-IMS, Chemistry Department, University of Coimbra, Coimbra 3004-535, Portugal
| | | | - Luis G Arnaut
- CQC-IMS, Chemistry Department, University of Coimbra, Coimbra 3004-535, Portugal
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Yousefi M, Ghahremanzadeh R, Nejadmoghaddam MR, Samadi FY, Najafzadeh S, Fatideh FM, Mohammadi Z, Minai-Tehrani A. Nanofabrication of chitosan-based dressing to treat the infected wounds: in vitro and in vivo evaluations. Future Sci OA 2024; 10:FSO921. [PMID: 38827799 PMCID: PMC11140651 DOI: 10.2144/fsoa-2023-0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 10/12/2023] [Indexed: 06/05/2024] Open
Abstract
Aim: Here, an innovative kind of antibacterial nanocomposite film is developed by incorporating graphene oxide and zinc oxide into chitosan matrix. Materials & methods: Our dressing was fabricated using the solution casting method. Fourier transform infrared spectra and TGA-DTG clearly confirmed the structure of film dressing. Results & conclusion: Our results showed the tensile strength and elongation at the break of the films were 20.1 ± 0.7 MPa and 36 ± 10%, respectively. Our fabricated film could absorb at least three-times the fluid of its dry weight while being biocompatible, antibacterial, non-irritant and non-allergic. In addition, it accelerated the healing process of infected wounds by regulating epithelium thickness and the number of inflammatory cells, thus it may be useful for direct application to damaged infected wounds.
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Affiliation(s)
- Maryam Yousefi
- Nanobiotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, 1983969412, Iran
| | - Ramin Ghahremanzadeh
- Nanobiotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, 1983969412, Iran
| | | | - Fatemeh Yazdi Samadi
- Nanobiotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, 1983969412, Iran
| | - Somayeh Najafzadeh
- Nanobiotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, 1983969412, Iran
| | | | - Zohreh Mohammadi
- Department of Pharmaceutics & Pharmaceutical Nanotechnology, School of Pharmacy, Iran University of Medical Sciences, Tehran, 1475886973, Iran
| | - Arash Minai-Tehrani
- Nanobiotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, 1983969412, Iran
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Aleksandrova YI, Shurpik DN, Nazmutdinova VA, Zelenikhin PV, Subakaeva EV, Sokolova EA, Leonteva YO, Mironova AV, Kayumov AR, Petrovskii VS, Potemkin II, Stoikov II. Antibacterial Activity of Various Morphologies of Films Based on Guanidine Derivatives of Pillar[5]arene: Influence of the Nature of One Substitute on Self-assembly. ACS APPLIED MATERIALS & INTERFACES 2024; 16:17163-17181. [PMID: 38530408 DOI: 10.1021/acsami.3c18610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
The progress of the pillar[5]arene chemistry allowed us to set out a new concept on application of the supramolecular assemblies to create antimicrobial films with variable surface morphologies and biological activities. Antibacterial films were derived from the substituted pillar[5]arenes containing nine pharmacophoric guanidine fragments and one thioalkyl substituent. Changing the only thioalkyl fragment in the macrocycle structure made it possible to control the biological activity of the resulting antibacterial coating. Pretreatment of the surface with aqueous solution of the amphiphilic pillar[5]arenes reduced the biofilm thickness by 56 ± 10% of Gram-positive Staphylococcus aureus in the case of the pillar[5]arene containing a thiooctyl fragment and by 52 ± 7% for the biofilm of Gram-negative Klebsiella pneumoniae in the case of pillar[5]arene containing a thiooctadecyl fragment. Meanwhile, the cytotoxicity of the synthesized macrocycles was examined at a concentration of 50 μg/mL, which was significantly lower than that of bis-guanidine-based antimicrobial preparations.
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Affiliation(s)
- Yulia I Aleksandrova
- A. M. Butlerov Chemistry Institute, Kazan Federal University, 420008 Kremlevskaya Street, 18, Kazan, Russian Federation
| | - Dmitriy N Shurpik
- A. M. Butlerov Chemistry Institute, Kazan Federal University, 420008 Kremlevskaya Street, 18, Kazan, Russian Federation
| | - Viktoriya A Nazmutdinova
- A. M. Butlerov Chemistry Institute, Kazan Federal University, 420008 Kremlevskaya Street, 18, Kazan, Russian Federation
| | - Pavel V Zelenikhin
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kremlevskaya, 18, Kazan, Russian Federation
| | - Evgeniya V Subakaeva
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kremlevskaya, 18, Kazan, Russian Federation
| | - Evgeniya A Sokolova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kremlevskaya, 18, Kazan, Russian Federation
| | - Yulia O Leonteva
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kremlevskaya, 18, Kazan, Russian Federation
| | - Anna V Mironova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kremlevskaya, 18, Kazan, Russian Federation
| | - Airat R Kayumov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kremlevskaya, 18, Kazan, Russian Federation
| | - Vladislav S Petrovskii
- Physics Department, M. V. Lomonosov Moscow State University, Leninskie Gory 1-2, 119991 Moscow, Russian Federation
- N. N. Semenov Federal Research Center of Chemical Physics of Russian Academy of Sciences, Kosygina 4, 119991 Moscow, Russian Federation
| | - Igor I Potemkin
- Physics Department, M. V. Lomonosov Moscow State University, Leninskie Gory 1-2, 119991 Moscow, Russian Federation
| | - Ivan I Stoikov
- A. M. Butlerov Chemistry Institute, Kazan Federal University, 420008 Kremlevskaya Street, 18, Kazan, Russian Federation
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Feng Y, Qin S, Li H, Yang Y, Zheng Y, Liu H, Yap WY, Zhou X, Wen J. Composite Hydrogel Dressings with Enhanced Mechanical Properties and Anti-Inflammatory Ability for Effectively Promoting Wound Repair. Int J Nanomedicine 2023; 18:5183-5195. [PMID: 37720596 PMCID: PMC10503508 DOI: 10.2147/ijn.s411478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/01/2023] [Indexed: 09/19/2023] Open
Abstract
Background Hydrogel dressings have been used as a crucial method to keep the wound wet and hasten the healing process. Due to safety concerns regarding the gel components, low mechanical adhesiveness, and unsatisfactory anti-inflammatory capacity qualities for practical uses in vivo, leading to the clinical translation of wound dressings is still difficult. Methods A type of composite hydrogel (acrylamide/polyethylene glycol diacrylate/tannic acid, ie, AM/PEGDA/TA) by double bond crosslinking, Schiff base, and hydrogen bond interaction is proposed. The mechanical characteristics, adhesiveness, and biocompatibility of the hydrogel system were all thoroughly examined. Additionally, a full-thickness cutaneous wound model was employed to assess the in vivo wound healing capacity of resulting hydrogel dressings. Results Benefiting the mechanism of multiple crosslinking, the designed composite hydrogels showed significant mechanical strength, outstanding adhesive capability, and good cytocompatibility. Moreover, the hydrogel system also had excellent shape adaptability, and they can be perfectly integrated into the irregularly shaped wounds through a fast in situ forming approach. Additional in vivo tests supported the findings that the full-thickness wound treated with the composite hydrogels showed quicker epithelial tissue regeneration, fewer inflammatory cells, more collagen deposition, and greater levels of platelet endothelial cell adhesion molecule (CD31) expression. Conclusion These above results might offer a practical and affordable product or method of skin wound therapy in a medical context.
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Affiliation(s)
- Yuqin Feng
- Department of Dermatology, the Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People’s Republic of China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510280, People’s Republic of China
| | - Si Qin
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People’s Republic of China
| | - Huarun Li
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People’s Republic of China
| | - Yemei Yang
- Department of Dermatology, the Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People’s Republic of China
| | - Yushi Zheng
- Department of Dermatology, the Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People’s Republic of China
| | - Hongsheng Liu
- Guangdong Huace Life Medicine Research Center, Guangzhou, 511450, People’s Republic of China
| | - Wei Yin Yap
- Department of Dermatology, the Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People’s Republic of China
- School of International Education of Southern Medical University, Guangzhou, 510515, People’s Republic of China
| | - Xianyi Zhou
- Department of Dermatology, the Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People’s Republic of China
| | - Ju Wen
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510280, People’s Republic of China
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, 510317, People’s Republic of China
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Varma A, Warghane A, Dhiman NK, Paserkar N, Upadhye V, Modi A, Saini R. The role of nanocomposites against biofilm infections in humans. Front Cell Infect Microbiol 2023; 13:1104615. [PMID: 36926513 PMCID: PMC10011468 DOI: 10.3389/fcimb.2023.1104615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/30/2023] [Indexed: 03/08/2023] Open
Abstract
The use of nanomaterials in several fields of science has undergone a revolution in the last few decades. It has been reported by the National Institutes of Health (NIH) that 65% and 80% of infections are accountable for at least 65% of human bacterial infections. One of their important applications in healthcare is the use of nanoparticles (NPs) to eradicate free-floating bacteria and those that form biofilms. A nanocomposite (NC) is a multiphase stable fabric with one or three dimensions that are much smaller than 100 nm, or systems with nanoscale repeat distances between the unique phases that make up the material. Using NC materials to get rid of germs is a more sophisticated and effective technique to destroy bacterial biofilms. These biofilms are refractory to standard antibiotics, mainly to chronic infections and non-healing wounds. Materials like graphene and chitosan can be utilized to make several forms of NCs, in addition to different metal oxides. The ability of NCs to address the issue of bacterial resistance is its main advantage over antibiotics. This review highlights the synthesis, characterization, and mechanism through which NCs disrupt Gram-positive and Gram-negative bacterial biofilms, and their relative benefits and drawbacks. There is an urgent need to develop materials like NCs with a larger spectrum of action due to the rising prevalence of human bacterial diseases that are multidrug-resistant and form biofilms.
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Affiliation(s)
- Anand Varma
- Arundeep Akshay Urja Pvt. Ltd. Gorakhpur, Uttar Pradesh, India
| | - Ashish Warghane
- School of Applied Sciences and Technology (SAST), Gujarat Technological University, Ahmedabad, Gujarat, India
| | - Neena K. Dhiman
- Department of Zoology, Gargi College, University of Delhi, Delhi, India
| | - Neha Paserkar
- Faculty of Life Sciences, Mandsaur University, Mandsaur, Madhya Pradesh, India
| | - Vijay Upadhye
- Centre of Research for Development (CR4D), Parul University, Vadodara, Gujarat, India
| | - Anupama Modi
- School of Applied Sciences and Technology (SAST), Gujarat Technological University, Ahmedabad, Gujarat, India
| | - Rashmi Saini
- Department of Zoology, Gargi College, University of Delhi, Delhi, India
- *Correspondence: Rashmi Saini,
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Kwasi DA, Babalola CP, Olubiyi OO, Hoffmann J, Uzochukwu IC, Okeke IN. Antibiofilm agents with therapeutic potential against enteroaggregative Escherichia coli. PLoS Negl Trop Dis 2022; 16:e0010809. [PMID: 36201560 PMCID: PMC9578610 DOI: 10.1371/journal.pntd.0010809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 10/18/2022] [Accepted: 09/12/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Enteroaggregative Escherichia coli (EAEC) is a predominant but neglected enteric pathogen implicated in infantile diarrhoea and nutrient malabsorption. There are no non-antibiotic approaches to dealing with persistent infection by these exceptional colonizers, which form copious biofilms. We screened the Medicines for Malaria Venture Pathogen Box for chemical entities that inhibit EAEC biofilm formation. METHODOLOGY We used EAEC strains, 042 and MND005E in a medium-throughput crystal violet-based antibiofilm screen. Hits were confirmed in concentration-dependence, growth kinetic and time course assays and activity spectra were determined against a panel of 25 other EAEC strains. Antibiofilm activity against isogenic EAEC mutants, molecular docking simulations and comparative genomic analysis were used to identify the mechanism of action of one hit. PRINCIPAL FINDINGS In all, five compounds (1.25%) reproducibly inhibited biofilm accumulation by at least one strain by 30-85% while inhibiting growth by under 10%. Hits exhibited potent antibiofilm activity at concentrations at least 10-fold lower than those reported for nitazoxanide, the only known EAEC biofilm inhibitor. Reflective of known EAEC heterogeneity, only one hit was active against both screen isolates, but three hits showed broad antibiofilm activity against a larger panel of strains. Mechanism of action studies point to the EAEC anti-aggregation protein (Aap), dispersin, as the target of compound MMV687800. CONCLUSIONS This study identified five compounds, not previously described as anti-adhesins or Gram-negative antibacterials, with significant EAEC antibiofilm activity. Molecule, MMV687800 targets the EAEC Aap. In vitro small-molecule inhibition of EAEC colonization opens a way to new therapeutic approaches against EAEC infection.
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Affiliation(s)
- David A. Kwasi
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Oyo State, Nigeria
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Chinedum P. Babalola
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
- Center for Drug Discovery, Development and Production, Faculty of Pharmacy, University of Ibadan, Oyo State, Nigeria
| | - Olujide O. Olubiyi
- Department of Pharmaceutical and Medicinal Chemistry, College of Pharmacy, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Jennifer Hoffmann
- Department of Biology, Haverford College, Haverford, Pennsylvania, United States of America
| | - Ikemefuna C. Uzochukwu
- Department of Pharmaceutical and Medicinal Chemistry, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University Awka, Anambra State, Nigeria
| | - Iruka N. Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Oyo State, Nigeria
- Department of Biology, Haverford College, Haverford, Pennsylvania, United States of America
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Gupta S, Shinde S, Shinde RK. Topical Management of Wound: A Narrative Review of Cadexomer Iodine Ointment Versus Povidone Iodine Ointment. Cureus 2022; 14:e24598. [PMID: 35651379 PMCID: PMC9138860 DOI: 10.7759/cureus.24598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/05/2022] Open
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Biofilm Survival Strategies in Chronic Wounds. Microorganisms 2022; 10:microorganisms10040775. [PMID: 35456825 PMCID: PMC9025119 DOI: 10.3390/microorganisms10040775] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 01/22/2023] Open
Abstract
Bacterial biofilms residing in chronic wounds are thought to have numerous survival strategies, making them extremely difficult to eradicate and resulting in long-term infections. However, much of our knowledge regarding biofilm persistence stems from in vitro models and experiments performed in vivo in animal models. While the knowledge obtained from such experiments is highly valuable, its direct translation to the human clinical setting should be undertaken with caution. In this review, we highlight knowledge obtained from human clinical samples in different aspects of biofilm survival strategies. These strategies have been divided into segments of the following attributes: altered transcriptomic profiles, spatial distribution, the production of extracellular polymeric substances, an altered microenvironment, inter-and intra-species interactions, and heterogeneity in the bacterial population. While all these attributes are speculated to contribute to the enhanced persistence of biofilms in chronic wounds, only some of them have been demonstrated to exist in human wounds. Some of the attributes have been observed in other clinical diseases while others have only been observed in vitro. Here, we have strived to clarify the limitations of the current knowledge in regard to this specific topic, without ignoring important in vitro and in vivo observations.
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Cheong JZA, Liu A, Rust CJ, Tran CL, Hassan SE, Kalan LR, Gibson ALF. Robbing Peter to Pay Paul: Chlorhexidine gluconate demonstrates short-term efficacy and long-term cytotoxicity. Wound Repair Regen 2022; 30:573-584. [PMID: 36638156 PMCID: PMC9542784 DOI: 10.1111/wrr.13044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 01/27/2023]
Abstract
Wound cleansing agents are routine in wound care and preoperative preparation. Antiseptic activity intends to prevent contaminating microbes from establishing an infection while also raising concerns of cytotoxicity and delayed wound healing. We evaluated the cytotoxicity of five clinically used wound cleaning agents (saline, povidone iodine, Dove® and Dial® soaps, and chlorhexidine gluconate [CHG]) using both an ex vivo and in vivo human skin xenograft mouse model, in contrast to classical in vitro models that lack the structural and compositional heterogeneity of human skin. We further established an ex vivo wound contamination model inoculated with ~100 cells of Pseudomonas aeruginosa or Staphylococcus aureus to evaluate antimicrobial efficacy. Scanning electron microscopy and confocal microscopy were used to evaluate phenotypic and spatial characteristics of bacterial cells in wound tissue. CHG significantly reduced metabolic activity of the skin explants, while all treatments except saline affected local cellular viability. CHG cytotoxicity persisted and progressed over 14 days, impairing wound healing in vivo. Within the contamination model, CHG treatment resulted in a significant reduction of P. aeruginosa wound surface counts at 24 h post-treatment. However, this effect was transient and serial application of CHG had no effect on both P. aeruginosa or S. aureus microbial growth. Microscopy revealed that viable cells of P. aeruginosa reside deep within wound tissue post-CHG application, likely serving as a reservoir to re-populate the tissue to a high bioburden. We reveal concerning cytotoxicity and limited antimicrobial activity of CHG in human skin using clinically relevant models, with the ability to resolve spatial localization and temporal dynamics of tissue viability and microbial growth.
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Affiliation(s)
- J. Z. Alex Cheong
- Department of Medical Microbiology and ImmunologyUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA,Microbiology Doctoral Training ProgramUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Aiping Liu
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Clayton J. Rust
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Collin L. Tran
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sameeha E. Hassan
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Lindsay R. Kalan
- Department of Medical Microbiology and ImmunologyUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA,Department of Medicine, Division of Infectious DiseaseUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Angela L. F. Gibson
- Department of SurgeryUniversity of Wisconsin–Madison, School of Medicine and Public HealthMadisonWisconsinUSA
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Derwin R, Patton D, Avsar P, Strapp H, Moore Z. The impact of topical agents and dressing on pH and temperature on wound healing: A systematic, narrative review. Int Wound J 2021; 19:1397-1408. [PMID: 34931445 PMCID: PMC9493238 DOI: 10.1111/iwj.13733] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/14/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022] Open
Abstract
To assess the impact of topical agents and dressings on surface wound pH, temperature, and subsequent wound healing. This was a systematic, narrative review of the literature, following the PRISMA (2020) guidelines. The databases searched were Medline PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Embase, Web of Science, and Scopus. Data synthesis and analysis were conducted using a structured narrative synthesis. The quality of the included clinical studies was appraised using the Evidence-Based Literature (EBL) Critical Appraisal Tool. A total of six clinical studies were assessed as eligible for inclusion, A total of six dressings/topical agents were assessed and the types of wounds included non-healing chronic wounds. Of the studies, five explored pH and one explored temperature. The EBL validity of the clinical studies was low (mean quality score was 51.3%). The five clinical studies that explored pH investigated different dressings and topical agents reporting an associated reduction in pH and improved wound outcomes. One clinical study investigated the impact of topical sodium nitrite on temperature and found that sodium nitrite increased peri-wound skin temperature and improved wound outcomes with a reduction in leg ulcer size. Given the low certainty of the evidence, we cannot confidently recommend the use of any particular topical agent or dressing to manipulate pH, or temperature to improve wound outcomes. Thus, there is a need for further research to develop a greater understanding of this topic. Irish Research Council, Enterprise Partnership Scheme.
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Affiliation(s)
- Rosemarie Derwin
- School of Nursing and Midwifery, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland
| | - Declan Patton
- Wounds and Trauma Research Centre, School of Nursing and Midwifery, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.,Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.,Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Pinar Avsar
- Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland
| | - Helen Strapp
- Department of Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Zena Moore
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.,Head of School of Nursing and Midwifery and Director of the Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.,Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Nursing, Lida Institute, Shanghai, China.,School of Nursing and Midwifery, University of Wales, Cardiff, UK
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Vereshchagin AN, Frolov NA, Egorova KS, Seitkalieva MM, Ananikov VP. Quaternary Ammonium Compounds (QACs) and Ionic Liquids (ILs) as Biocides: From Simple Antiseptics to Tunable Antimicrobials. Int J Mol Sci 2021; 22:6793. [PMID: 34202677 PMCID: PMC8268321 DOI: 10.3390/ijms22136793] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
Quaternary ammonium compounds (QACs) belong to a well-known class of cationic biocides with a broad spectrum of antimicrobial activity. They are used as essential components in surfactants, personal hygiene products, cosmetics, softeners, dyes, biological dyes, antiseptics, and disinfectants. Simple but varied in their structure, QACs are divided into several subclasses: Mono-, bis-, multi-, and poly-derivatives. Since the beginning of the 20th century, a significant amount of work has been dedicated to the advancement of this class of biocides. Thus, more than 700 articles on QACs were published only in 2020, according to the modern literature. The structural variability and diverse biological activity of ionic liquids (ILs) make them highly prospective for developing new types of biocides. QACs and ILs bear a common key element in the molecular structure-quaternary positively charged nitrogen atoms within a cyclic or acyclic structural framework. The state-of-the-art research level and paramount demand in modern society recall the rapid development of a new generation of tunable antimicrobials. This review focuses on the main QACs exhibiting antimicrobial and antifungal properties, commercial products based on QACs, and the latest discoveries in QACs and ILs connected with biocide development.
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Affiliation(s)
- Anatoly N. Vereshchagin
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991 Moscow, Russia; (N.A.F.); (K.S.E.); (M.M.S.)
| | | | | | | | - Valentine P. Ananikov
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991 Moscow, Russia; (N.A.F.); (K.S.E.); (M.M.S.)
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12
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Alves PJ, Barreto RT, Barrois BM, Gryson LG, Meaume S, Monstrey SJ. Update on the role of antiseptics in the management of chronic wounds with critical colonisation and/or biofilm. Int Wound J 2021; 18:342-358. [PMID: 33314723 PMCID: PMC8244012 DOI: 10.1111/iwj.13537] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/04/2020] [Accepted: 11/07/2020] [Indexed: 12/22/2022] Open
Abstract
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.
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Affiliation(s)
- Paulo J. Alves
- Wounds Research LaboratoryUniversidade Católica PortuguesaPortoPortugal
| | | | | | - Luc G. Gryson
- Belgian Defence Military Medical ComponentBrusselsBelgium
| | - Sylvie Meaume
- Department of Geriatrics and Wound Care UnitHospital Rothschild, APHP Assistance Publique Hôpitaux de Paris, Sorbonne UniversitéParisFrance
| | - Stan J. Monstrey
- Department of Plastic SurgeryGhent University HospitalGhentBelgium
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13
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Zhang K, Raju C, Zhong W, Pethe K, Gründling A, Chan-Park MB. Cationic Glycosylated Block Co-β-peptide Acts on the Cell Wall of Gram-Positive Bacteria as Anti-biofilm Agents. ACS APPLIED BIO MATERIALS 2021; 4:3749-3761. [PMID: 35006805 DOI: 10.1021/acsabm.0c01241] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Antimicrobial resistance is a global threat. In addition to the emergence of resistance to last resort drugs, bacteria escape antibiotics killing by forming complex biofilms. Strategies to tackle antibiotic resistance as well as biofilms are urgently needed. Wall teichoic acid (WTA), a generic anionic glycopolymer present on the cell surface of many Gram-positive bacteria, has been proposed as a possible therapeutic target, but its druggability remains to be demonstrated. Here we report a cationic glycosylated block co-β-peptide that binds to WTA. By doing so, the co-β-peptide not only inhibits biofilm formation, it also disperses preformed biofilms in several Gram-positive bacteria and resensitizes methicillin-resistant Staphylococcus aureus to oxacillin. The cationic block of the co-β-peptide physically interacts with the anionic WTA within the cell envelope, whereas the glycosylated block forms a nonfouling corona around the bacteria. This reduces physical interaction between bacteria-substrate and bacteria-biofilm matrix, leading to biofilm inhibition and dispersal. The WTA-targeting co-β-peptide is a promising lead for the future development of broad-spectrum anti-biofilm strategies against Gram-positive bacteria.
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Affiliation(s)
- Kaixi Zhang
- School of Chemical and Biomedical Engineering, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459.,Centre for Antimicrobial Bioengineering, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459
| | - Cheerlavancha Raju
- School of Chemical and Biomedical Engineering, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459.,Centre for Antimicrobial Bioengineering, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459
| | - Wenbin Zhong
- School of Chemical and Biomedical Engineering, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459.,Centre for Antimicrobial Bioengineering, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459
| | - Kevin Pethe
- Centre for Antimicrobial Bioengineering, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459.,Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Singapore 636921.,School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551
| | - Angelika Gründling
- Faculty of Medicine, Department of Infectious Disease, Imperial College London, Flowers Building London, London SW7 2AZ, United Kingdom
| | - Mary B Chan-Park
- School of Chemical and Biomedical Engineering, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459.,Centre for Antimicrobial Bioengineering, Nanyang Technological University, 62 Nanyang Drive, Singapore 637459.,Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Singapore 636921
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14
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Bordin P. Low-Concentration (0.66%) Povidone Iodine Treatment of a Corneal Ulcer in a Rheumatoid Arthritis Patient. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e928748. [PMID: 33746199 PMCID: PMC8006477 DOI: 10.12659/ajcr.928748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Patient: Female, 89-year-old Final Diagnosis: Corneal ulcer Symptoms: Low vision Medication:— Clinical Procedure: — Specialty: Ophthalmology
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Affiliation(s)
- Paolo Bordin
- Department of Ophthalmology, ULSS9 Scaligera, Legnago Hospital, Verona, Italy
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15
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Wang XF, Li ML, Fang QQ, Zhao WY, Lou D, Hu YY, Chen J, Wang XZ, Tan WQ. Flexible electrical stimulation device with Chitosan-Vaseline® dressing accelerates wound healing in diabetes. Bioact Mater 2021; 6:230-243. [PMID: 32913931 PMCID: PMC7451868 DOI: 10.1016/j.bioactmat.2020.08.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 12/16/2022] Open
Abstract
The healing process of diabetic wounds is typically disordered and prolonged and requires both angiogenesis and epithelialization. Disruptions of the endogenous electric fields (EFs) may lead to disordered cell migration. Electrical stimulation (ES) that mimics endogenous EFs is a promising method in treating diabetic wounds; however, a microenvironment that facilitates cell migration and a convenient means that can be used to apply ES are also required. Chitosan-Vaseline® gauze (CVG) has been identified to facilitate wound healing; it also promotes moisture retention and immune regulation and has antibacterial activity. For this study, we created a wound dressing using CVG together with a flexible ES device and further evaluated its potential as a treatment for diabetic wounds. We found that high voltage monophasic pulsed current (HVMPC) promoted healing of diabetic wounds in vivo. In studies carried out in vitro, we found that HVMPC promoted the proliferation and migration of human umbilical vein endothelial cells (HUVECs) by activating PI3K/Akt and ERK1/2 signaling. Overall, we determined that the flexible ES-chitosan dressing may promoted healing of diabetic wounds by accelerating angiogenesis, enhancing epithelialization, and inhibiting scar formation. These findings provide support for the ongoing development of this multidisciplinary product for the care and treatment of diabetic wounds.
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Affiliation(s)
- Xiao-Feng Wang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang Province, PR China
| | - Meng-Lu Li
- Key Laboratory of Micro-Nano Electronic Devices and Smart Systems of Zhejiang Province, College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, 310027, Zhejiang Province, PR China
| | - Qing-Qing Fang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang Province, PR China
| | - Wan-Yi Zhao
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang Province, PR China
| | - Dong Lou
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang Province, PR China
| | - Yan-Yan Hu
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang Province, PR China
| | - Jun Chen
- Innovation Center for Signaling Network, College of Life Sciences, Zhejiang University, Hangzhou, 310058, Zhejiang Province, PR China
| | - Xiao-Zhi Wang
- Key Laboratory of Micro-Nano Electronic Devices and Smart Systems of Zhejiang Province, College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, 310027, Zhejiang Province, PR China
| | - Wei-Qiang Tan
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang Province, PR China
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16
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Trizna EY, Yarullina MN, Baidamshina DR, Mironova AV, Akhatova FS, Rozhina EV, Fakhrullin RF, Khabibrakhmanova AM, Kurbangalieva AR, Bogachev MI, Kayumov AR. Bidirectional alterations in antibiotics susceptibility in Staphylococcus aureus-Pseudomonas aeruginosa dual-species biofilm. Sci Rep 2020; 10:14849. [PMID: 32908166 PMCID: PMC7481796 DOI: 10.1038/s41598-020-71834-w] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 08/18/2020] [Indexed: 12/12/2022] Open
Abstract
In mixed infections, the bacterial susceptibility differs significantly compared to monocultures of bacteria, and generally the concentrations of antibiotics required for the treatment increases drastically. For S. aureus and P. aeruginosa dual species biofilms, it has been numerously reported that P. aeruginosa decreases S. aureus susceptibility to a broad range of antibiotics, including beta-lactams, glycopeptides, aminoglycosides, macrolides, while sensitizes to quinolones via secretion of various metabolites. Here we show that S. aureus also modulates the susceptibility of P. aeruginosa to antibiotics in mixed cultures. Thus, S. aureus-P. aeruginosa consortium was characterized by tenfold increase in susceptibility to ciprofloxacin and aminoglycosides compared to monocultures. The same effect could be also achieved by the addition of cell-free culture of S. aureus to P. aeruginosa biofilm. Moreover, similar increase in antibiotics efficacy could be observed following addition of S. aureus suspension to the P. aeruginosa mature biofilm, compared to P. aeruginosa monoculture, and vice versa. These findings open promising perspectives to increase the antimicrobial treatment efficacy of the wounds infected with nosocomial pathogens by the transplantation of the skin residential microflora.
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Affiliation(s)
- Elena Y Trizna
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Maria N Yarullina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Diana R Baidamshina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Anna V Mironova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Farida S Akhatova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Elvira V Rozhina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Rawil F Fakhrullin
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Alsu M Khabibrakhmanova
- Biofunctional Chemistry Laboratory, A. Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Almira R Kurbangalieva
- Biofunctional Chemistry Laboratory, A. Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Mikhail I Bogachev
- Biomedical Engineering Research Centre, St. Petersburg Electrotechnical University, St. Petersburg, Russian Federation
| | - Airat R Kayumov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation.
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17
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Kuo SH, Shen CJ, Shen CF, Cheng CM. Role of pH Value in Clinically Relevant Diagnosis. Diagnostics (Basel) 2020; 10:diagnostics10020107. [PMID: 32079129 PMCID: PMC7167948 DOI: 10.3390/diagnostics10020107] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 12/18/2022] Open
Abstract
As a highly influential physiological factor, pH may be leveraged as a tool to diagnose physiological state. It may be especially suitable for diagnosing and assessing skin structure and wound status. Multiple innovative and elegant smart wound dressings combined with either pH sensors or drug control-released carriers have been extensively studied. Increasing our understanding of the role of pH value in clinically relevant diagnostics should assist clinicians and improve personal health management in the home. In this review, we summarized a number of articles and discussed the role of pH on the skin surface as well as the factors that influence skin pH and pH-relevant skin diseases, but also the relationship of skin pH to the wound healing process, including its influence on the activity of proteases, bacterial enterotoxin, and some antibacterial agents. A great number of papers discussing physiological pH value have been published in recent decades, far too many to be included in this review. Here, we have focused on the impact of pH on wounds and skin with an emphasis on clinically relevant diagnosis toward effective treatment. We have also summarized the differences in skin structure and wound care between adults and infants, noting that infants have fragile skin and poor skin barriers, which makes them more vulnerable to skin damage and compels particular care, especially for wounds.
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Affiliation(s)
- Shu-Hua Kuo
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 300, Taiwan;
| | - Ching-Ju Shen
- College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Ching-Fen Shen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
- Correspondence: (C.-F.S.); (C.-M.C.)
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 300, Taiwan;
- Correspondence: (C.-F.S.); (C.-M.C.)
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18
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Weldrick PJ, Hardman MJ, Paunov VN. Enhanced Clearing of Wound-Related Pathogenic Bacterial Biofilms Using Protease-Functionalized Antibiotic Nanocarriers. ACS APPLIED MATERIALS & INTERFACES 2019; 11:43902-43919. [PMID: 31718141 DOI: 10.1021/acsami.9b16119] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Biofilms are prevalent in chronic wounds and once formed are very hard to remove, which is associated with poor outcomes and high mortality rates. Biofilms are comprised of surface-attached bacteria embedded in an extracellular polymeric substance (EPS) matrix, which confers increased antibiotic resistance and host immune evasion. Therefore, disruption of this matrix is essential to tackle the biofilm-embedded bacteria. Here, we propose a novel nanotechnology to do this, based on protease-functionalized nanogel carriers of antibiotics. Such active antibiotic nanocarriers, surface coated with the protease Alcalase 2.4 L FG, "digest" their way through the biofilm EPS matrix, reach the buried bacteria, and deliver a high dose of antibiotic directly on their cell walls, which overwhelms their defenses. We demonstrated their effectiveness against six wound biofilm-forming bacteria, Staphylococcus aureus, Pseudomonas aeruginosa, Staphylococcus epidermidis, Klebsiella pneumoniae, Escherichia coli, and Enterococcus faecalis. We confirmed a 6-fold decrease in the biofilm mass and a substantial reduction in bacterial cell density using fluorescence, atomic force, and scanning electron microscopy. Additionally, we showed that co-treatments of ciprofloxacin and Alcalase-coated Carbopol nanogels led to a 3-log reduction in viable biofilm-forming cells when compared to ciprofloxacin treatments alone. Encapsulating an equivalent concentration of ciprofloxacin into the Alcalase-coated nanogel particles boosted their antibacterial effect much further, reducing the bacterial cell viability to below detectable amounts after 6 h of treatment. The Alcalase-coated nanogel particles were noncytotoxic to human adult keratinocyte cells (HaCaT), inducing a very low apoptotic response in these cells. Overall, we demonstrated that the Alcalase-coated nanogels loaded with a cationic antibiotic elicit very strong biofilm-clearing effects against wound-associated biofilm-forming pathogenic bacteria. This nanotechnology approach has the potential to become a very powerful treatment of chronically infected wounds with biofilm-forming bacteria.
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Affiliation(s)
- Paul J Weldrick
- Department of Chemistry and Biochemistry , University of Hull , Hull HU6 7RX , U.K
| | - Matthew J Hardman
- Centre for Atherothrombosis and Metabolic Disease , Hull York Medical School , Hull HU6 7RX , U.K
| | - Vesselin N Paunov
- Department of Chemistry and Biochemistry , University of Hull , Hull HU6 7RX , U.K
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19
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Panchmatia R, Payandeh J, Al-Salman R, Kakande E, Habib AR, Mullings W, Javer AR. The efficacy of diluted topical povidone-iodine rinses in the management of recalcitrant chronic rhinosinusitis: a prospective cohort study. Eur Arch Otorhinolaryngol 2019; 276:3373-3381. [PMID: 31560120 DOI: 10.1007/s00405-019-05628-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/31/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE Recalcitrant chronic rhinosinusitis is a persistent inflammatory condition of the sinonasal mucosa despite adequate medical therapy and sinus surgery. This study aimed to demonstrate the effectiveness and safety of dilute povidone-iodine (PVP-I) sinonasal rinses as an adjunctive therapy. METHODS Prospective cohort study. Twenty-nine recalcitrant CRS patients with endoscopic evidence of ongoing inflammation and purulent discharge were prescribed 0.08% diluted PVP-I rinses. Changes to endoscopic modified Lund-Kennedy (MLK) scores at 7 weeks post-PVP-I rinsing served as the primary outcome measure. RESULTS The median MLK-discharge score significantly decreased in all patients by 1.50 points post-PVP-I rinsing (p value < 0.01). The total MLK score significantly decreased in all patients by 1.50 points (p value = 0.01). Up to a 17% reduction in serum inflammatory markers was measured post-PVP-I rinsing. Sinonasal culture revealed a shift from moderate-heavy growth to lighter bacterial growth overall. Subjective SNOT-22 scores significantly improved overall by ≥ 1 minimal clinically important difference (MCID > 12; baseline median = 33; follow-up median = 20; p value < 0.01; n = 22). TSH levels increased non-significantly within normal ranges (baseline median = 1.59 mU/L; follow-up median = 1.92 mU/L; p = 0.10; n = 15). Mucociliary clearance time increased non-significantly within normal ranges (baseline median = 9 min; follow-up median = 10 min; p value = 0.53; n = 17). Olfactory Sniffin'16 scores non-significantly decreased within age-related normal ranges (baseline median = 14; follow-up median = 13; p value = 0.72; n = 18). CONCLUSION A dilute 0.08% PVP-I sinonasal rinse as an ancillary therapy in recalcitrant CRS significantly reduces signs of infection alongside notable symptom improvement, without affecting thyroid function, mucociliary clearance or olfaction.
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Affiliation(s)
- Rikesh Panchmatia
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Payandeh
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Rami Al-Salman
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Emily Kakande
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Al-Rahim Habib
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Warren Mullings
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Amin R Javer
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada.
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20
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Piva RH, Rocha MC, Piva DH, Imasato H, Malavazi I, Rodrigues-Filho UP. Acidic Dressing Based on Agarose/Cs 2.5H 0.5PW 12O 40 Nanocomposite for Infection Control in Wound Care. ACS APPLIED MATERIALS & INTERFACES 2018; 10:30963-30972. [PMID: 30132323 DOI: 10.1021/acsami.8b09066] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Regulation of wound pH from alkaline to acidic is a simple and powerful approach to reduce wound microbial colonization and infection. Here, we present a nanocomposite material possessing intrinsic acidic surface pH as an innovative antimicrobial wound dressing. This material comprises an agarose matrix nanocomposite containing nanoparticles (NPs) of the cesium salt of phosphotungstic heteropolyacid (Cs2.5H0.5PW12O40). Self-supporting films were prepared by a casting method incorporating 5-20 wt % Cs2.5H0.5PW12O40 NPs into the matrix. Films are flexible with tensile strengths between 28.55 and 32.15 MPa and exhibit broad biocidal activity against neutralophilic pathogens, including Gram-positive bacteria, Gram-negative bacteria, yeast, and filamentous fungi. The nano-antimicrobial Cs2.5H0.5PW12O40 functions as an efficient and self-controlled proton delivery agent that lowers the surface pH of the nanocomposites to the range 7.0 > pH ≥ 3.0. Nanocomposite films containing 20 wt % Cs2.5H0.5PW12O40 NPs presented a surface pH of 3.0 and highest antimicrobial activity. Using quantitative reverse transcription polymerase chain reaction, we demonstrated that the antimicrobial mechanism of the nanocomposites is acid-induced because of the transcriptional induction of glutamate-dependent acid resistance genes in Escherichia coli. Additionally, nanocomposite films do not damage skin according to an in vivo rabbit skin model with no derived edema or erythema. The wound care safety of this material is due to low release of heavy metal heteropolyanions ([PW12O40]3-), no nanoparticle leaching, and proton controlled release resulting in nonirritating acid levels for human skin models.
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Affiliation(s)
- Roger H Piva
- Grupo de Química de Materiais Híbridos e Inorgânicos, Instituto de Química de São Carlos , Universidade de São Paulo , São Carlos São Paulo 13563-120 , Brazil
| | - Marina C Rocha
- Departamento de Genética e Evolução, Centro de Ciências Biológicas e da Saúde , Universidade Federal de São Carlos , São Carlos São Paulo 13565-905 , Brazil
| | - Diógenes H Piva
- Research Center on Advanced Materials and Energy , Federal University of São Carlos , São Carlos São Paulo 13565-905 , Brazil
| | - Hidetake Imasato
- Grupo de Química de Materiais Híbridos e Inorgânicos, Instituto de Química de São Carlos , Universidade de São Paulo , São Carlos São Paulo 13563-120 , Brazil
| | - Iran Malavazi
- Departamento de Genética e Evolução, Centro de Ciências Biológicas e da Saúde , Universidade Federal de São Carlos , São Carlos São Paulo 13565-905 , Brazil
| | - Ubirajara P Rodrigues-Filho
- Grupo de Química de Materiais Híbridos e Inorgânicos, Instituto de Química de São Carlos , Universidade de São Paulo , São Carlos São Paulo 13563-120 , Brazil
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21
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Roy R, Tiwari M, Donelli G, Tiwari V. Strategies for combating bacterial biofilms: A focus on anti-biofilm agents and their mechanisms of action. Virulence 2018; 9:522-554. [PMID: 28362216 PMCID: PMC5955472 DOI: 10.1080/21505594.2017.1313372] [Citation(s) in RCA: 698] [Impact Index Per Article: 116.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Biofilm refers to the complex, sessile communities of microbes found either attached to a surface or buried firmly in an extracellular matrix as aggregates. The biofilm matrix surrounding bacteria makes them tolerant to harsh conditions and resistant to antibacterial treatments. Moreover, the biofilms are responsible for causing a broad range of chronic diseases and due to the emergence of antibiotic resistance in bacteria it has really become difficult to treat them with efficacy. Furthermore, the antibiotics available till date are ineffective for treating these biofilm related infections due to their higher values of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), which may result in in-vivo toxicity. Hence, it is critically important to design or screen anti-biofilm molecules that can effectively minimize and eradicate biofilm related infections. In the present article, we have highlighted the mechanism of biofilm formation with reference to different models and various methods used for biofilm detection. A major focus has been put on various anti-biofilm molecules discovered or tested till date which may include herbal active compounds, chelating agents, peptide antibiotics, lantibiotics and synthetic chemical compounds along with their structures, mechanism of action and their respective MICs, MBCs, minimum biofilm inhibitory concentrations (MBICs) as well as the half maximal inhibitory concentration (IC50) values available in the literature so far. Different mode of action of anti biofilm molecules addressed here are inhibition via interference in the quorum sensing pathways, adhesion mechanism, disruption of extracellular DNA, protein, lipopolysaccharides, exopolysaccharides and secondary messengers involved in various signaling pathways. From this study, we conclude that the molecules considered here might be used to treat biofilm-associated infections after significant structural modifications, thereby investigating its effective delivery in the host. It should also be ensured that minimum effective concentration of these molecules must be capable of eradicating biofilm infections with maximum potency without posing any adverse side effects on the host.
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Affiliation(s)
- Ranita Roy
- a Department of Biochemistry , Central University of Rajasthan , Ajmer , India
| | - Monalisa Tiwari
- a Department of Biochemistry , Central University of Rajasthan , Ajmer , India
| | - Gianfranco Donelli
- b Microbial Biofilm Laboratory, IRCCS Fondazione Santa Lucia , Rome , Italy
| | - Vishvanath Tiwari
- a Department of Biochemistry , Central University of Rajasthan , Ajmer , India
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22
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Sharafutdinov IS, Trizna EY, Baidamshina DR, Ryzhikova MN, Sibgatullina RR, Khabibrakhmanova AM, Latypova LZ, Kurbangalieva AR, Rozhina EV, Klinger-Strobel M, Fakhrullin RF, Pletz MW, Bogachev MI, Kayumov AR, Makarewicz O. Antimicrobial Effects of Sulfonyl Derivative of 2(5 H)-Furanone against Planktonic and Biofilm Associated Methicillin-Resistant and -Susceptible Staphylococcus aureus. Front Microbiol 2017; 8:2246. [PMID: 29209288 PMCID: PMC5701942 DOI: 10.3389/fmicb.2017.02246] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/31/2017] [Indexed: 01/15/2023] Open
Abstract
The gram-positive opportunistic bacterium Staphylococcus aureus is one of the most common causatives of a variety of diseases including skin and skin structure infection or nosocomial catheter-associated infections. The biofilm formation that is an important virulence factor of this microorganism renders the antibiotic therapy ineffective, because biofilm-embedded bacteria exhibit strongly increased tolerance to antimicrobials. Here, we describe a novel 3-chloro-5(S)-[(1R,2S,5R)-2-isopropyl-5-methylcyclohexyloxy]-4-[4-methylphenylsulfonyl]-2(5H)-furanone (F105), possessing a sulfonyl group and l-menthol moiety. Minimal inhibitory and bactericidal concentration values (MIC and MBC) of F105 were 10 and 40 mg/L, respectively, suggesting F105 biocidal properties. F105 exhibits pronounced activity against biofilm-embedded S. aureus and increases the efficacy of aminoglycosides (amikacin, gentamicin, and kanamycin) and benzalkonium chloride with fractional inhibitory concentration index values of 0.33–0.44 and 0.29, respectively, suggesting an alternative external treatment option, e.g., for wound infections. Moreover, low concentrations (0.5–1.3 mg/L) of F105 reduced the MICs of these antimicrobials twofold. By using confocal laser scanning microscopy and CFU counting, we show explicitly that F105 also restores the antimicrobial activity of gentamicin and ampicillin against S. aureus biofilms by several orders of magnitude. Biofilm structures were not destroyed but sterilized, with embedded cells being almost completely killed at twofold MBC. While F105 is quite toxic (CC50/MBC ratio 0.2), our data suggest that the F105 chemotype might be a promising starting point for the development of complex topical agents for combined anti-staphylococcal biofilm-therapies restoring the efficacy of some antibiotics against difficult to treat S. aureus biofilm.
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Affiliation(s)
| | - Elena Y Trizna
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Diana R Baidamshina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Maria N Ryzhikova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Regina R Sibgatullina
- Biofunctional Chemistry Laboratory, Alexander Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Russia
| | - Alsu M Khabibrakhmanova
- Biofunctional Chemistry Laboratory, Alexander Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Russia
| | - Liliya Z Latypova
- Biofunctional Chemistry Laboratory, Alexander Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Russia
| | - Almira R Kurbangalieva
- Biofunctional Chemistry Laboratory, Alexander Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Russia
| | - Elvira V Rozhina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Mareike Klinger-Strobel
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Rawil F Fakhrullin
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Mathias W Pletz
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Mikhail I Bogachev
- Biomedical Engineering Research Centre, Saint Petersburg Electrotechnical University, Saint Petersburg, Russia
| | - Airat R Kayumov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Oliwia Makarewicz
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
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23
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Venkatesh M, Barathi VA, Goh ETL, Anggara R, Fazil MHUT, Ng AJY, Harini S, Aung TT, Fox SJ, Liu S, Yang L, Barkham TMS, Loh XJ, Verma NK, Beuerman RW, Lakshminarayanan R. Antimicrobial Activity and Cell Selectivity of Synthetic and Biosynthetic Cationic Polymers. Antimicrob Agents Chemother 2017; 61:e00469-17. [PMID: 28784676 PMCID: PMC5610535 DOI: 10.1128/aac.00469-17] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/29/2017] [Indexed: 12/20/2022] Open
Abstract
The mammalian and microbial cell selectivity of synthetic and biosynthetic cationic polymers has been investigated. Among the polymers with peptide backbones, polymers containing amino side chains display greater antimicrobial activity than those with guanidine side chains, whereas ethylenimines display superior activity over allylamines. The biosynthetic polymer ε-polylysine (εPL) is noncytotoxic to primary human dermal fibroblasts at concentrations of up to 2,000 μg/ml, suggesting that the presence of an isopeptide backbone has greater cell selectivity than the presence of α-peptide backbones. Both εPL and linear polyethylenimine (LPEI) exhibit bactericidal properties by depolarizing the cytoplasmic membrane and disrupt preformed biofilms. εPL displays broad-spectrum antimicrobial properties against antibiotic-resistant Gram-negative and Gram-positive strains and fungi. εPL elicits rapid bactericidal activity against both Gram-negative and Gram-positive bacteria, and its biocompatibility index is superior to those of cationic antiseptic agents and LPEI. εPL does not interfere with the wound closure of injured rabbit corneas. In a rabbit model of bacterial keratitis, the topical application of εPL (0.3%, wt/vol) decreases the bacterial burden and severity of infections caused by Pseudomonas aeruginosa and Staphylococcus aureus strains. In vivo imaging studies confirm that εPL-treated corneas appeared transparent and nonedematous compared to untreated infected corneas. Taken together, our results highlight the potential of εPL in resolving topical microbial infections.
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Affiliation(s)
- Mayandi Venkatesh
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Veluchamy Amutha Barathi
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
| | - Eunice Tze Leng Goh
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Raditya Anggara
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | | | - Alice Jie Ying Ng
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Sriram Harini
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Thet Tun Aung
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
| | - Stephen John Fox
- Bioinformatics Institute, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Shouping Liu
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
| | - Liang Yang
- Singapore Centre for Environmental Life Sciences, Nanyang Technological University, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
| | | | - Xian Jun Loh
- Institute of Materials Research and Engineering, A*STAR, Singapore
| | - Navin Kumar Verma
- Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, Singapore
| | - Roger W Beuerman
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
| | - Rajamani Lakshminarayanan
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
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24
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25
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Lu MM, Wang QJ, Chang ZM, Wang Z, Zheng X, Shao D, Dong WF, Zhou YM. Synergistic bactericidal activity of chlorhexidine-loaded, silver-decorated mesoporous silica nanoparticles. Int J Nanomedicine 2017; 12:3577-3589. [PMID: 28533681 PMCID: PMC5431745 DOI: 10.2147/ijn.s133846] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Combination of chlorhexidine (CHX) and silver ions could engender synergistic bactericidal effect and improve the bactericidal efficacy. It is highly desired to develop an efficient carrier for the antiseptics codelivery targeting infection foci with acidic microenvironment. In this work, monodisperse mesoporous silica nanoparticle (MSN) nanospheres were successfully developed as an ideal carrier for CHX and nanosilver codelivery through a facile and environmentally friendly method. The CHX-loaded, silver-decorated mesoporous silica nanoparticles (Ag-MSNs@CHX) exhibited a pH-responsive release manner of CHX and silver ions simultaneously, leading to synergistically antibacterial effect against both gram-positive Staphylococcus aureus and gram-negative Escherichia coli. Moreover, the effective antibacterial concentration of Ag-MSNs@CHX showed less cytotoxicity on normal cells. Given their synergistically bactericidal ability and good biocompatibility, these nanoantiseptics might have effective and broad clinical applications for bacterial infections.
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Affiliation(s)
- Meng-meng Lu
- Department of Dental Implantology, Jilin Province Key Laboratory of Tooth Development and Bone Remodeling, School and Hospital of Stomatology
| | - Qiu-jing Wang
- Experimental Center of Functional Sciences, College of Basic Medical Sciences, Jilin University, Changchun
| | - Zhi-min Chang
- Chinese Academy of Sciences Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou
| | - Zheng Wang
- Chinese Academy of Sciences Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou
| | - Xiao Zheng
- Department of Pharmacology, Nanomedicine Engineering Laboratory of Jilin Province, College of Basic Medical Sciences, Jilin University, Changchun, People’s Republic of China
| | - Dan Shao
- Chinese Academy of Sciences Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou
- Department of Pharmacology, Nanomedicine Engineering Laboratory of Jilin Province, College of Basic Medical Sciences, Jilin University, Changchun, People’s Republic of China
| | - Wen-fei Dong
- Chinese Academy of Sciences Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou
| | - Yan-min Zhou
- Department of Dental Implantology, Jilin Province Key Laboratory of Tooth Development and Bone Remodeling, School and Hospital of Stomatology
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26
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Kruse CR, Singh M, Targosinski S, Sinha I, Sørensen JA, Eriksson E, Nuutila K. The effect of pH on cell viability, cell migration, cell proliferation, wound closure, and wound reepithelialization: In vitro and in vivo study. Wound Repair Regen 2017; 25:260-269. [PMID: 28370923 DOI: 10.1111/wrr.12526] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 02/03/2017] [Accepted: 02/06/2017] [Indexed: 11/28/2022]
Abstract
Wound microenvironment plays a major role in the process of wound healing. It contains various external and internal factors that participate in wound pathophysiology. The pH is an important factor that influences wound healing by changing throughout the healing process. Several previous studies have investigated the role of pH in relation to pathogens but studies concentrating on the effects of pH on wound healing itself are inconclusive. The purpose of this study was to comprehensively and in a controlled fashion investigate the effect of pH on wound healing by studying its effect on human primary keratinocyte and fibroblast function in vitro and on wound healing in vivo. In vitro, primary human keratinocytes and fibroblasts were cultured in different levels of pH (5.5-12.5) and the effect on cell viability, proliferation, and migration was studied. A rat full-thickness wound model was used to investigate the effect of pH (5.5-9.5) on wound healing in vivo. The effect of pH on inflammation was monitored by measuring IL-1 α concentrations from wounds and cell cultures exposed to different pH environments. Our results showed that both skin cell types tolerated wide range of pH very well. They further demonstrated that both acidic and alkaline environments decelerated cell migration in comparison to neutral environments and interestingly alkaline conditions significantly enhanced cell proliferation. Results from the in vivo experiments indicated that a prolonged, strongly acidic wound environment prevents both wound closure and reepithelialization while a prolonged alkaline environment did not have any negative impact on wound closure or reepithelialization. Separately, both in vitro and in vivo studies showed that prolonged acidic conditions significantly increased the expression of IL-1 α in fibroblast cultures and in wound fluid, whereas prolonged alkaline conditions did not result in elevated amounts of IL-1 α.
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Affiliation(s)
- Carla R Kruse
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark
| | - Mansher Singh
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stefan Targosinski
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Indranil Sinha
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jens A Sørensen
- Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark
| | | | - Kristo Nuutila
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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27
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Hoekstra MJ, Westgate SJ, Mueller S. Povidone-iodine ointment demonstrates in vitro efficacy against biofilm formation. Int Wound J 2016; 14:172-179. [PMID: 26968574 PMCID: PMC7949843 DOI: 10.1111/iwj.12578] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 01/14/2016] [Accepted: 02/10/2016] [Indexed: 11/27/2022] Open
Abstract
Anti-infectives used to treat chronic exuding wounds are diluted by wound exudates, absorbed into dressings, metabolised by proteases and destroyed by pH. In order to mimic such effects of exudates, the efficacy of six topical wound agents was assessed undiluted and at 10% concentrations, including povidone-iodine ointment and a silver-impregnated wound dressing, to remove biofilms of Pseudomonas aeruginosa, multi-species biofilms of Candida albicans and methicillin-resistant Staphylococcus aureus (MRSA) in vitro in a Centers for Disease Control and Prevention (CDC) reactor. Povidone-iodine was also diluted to 3·3% and 33·3% of the commercial concentrations. Viable microorganisms in each preparation were quantified by colony count. No viable P. aeruginosa biofilm material was recovered after 4 and 24 hours of treatment with povidone-iodine ointment at the 100% and 10% concentrations. No C. albicans/MRSA biofilm material was recovered after 4 and 24 hours of treatment with povidone-iodine ointment at the 100% concentration. In general, following dilution, povidone-iodine ointment appeared to exhibit greater biofilm removal than the other agents tested. Further research involving different microorganisms in vitro and in vivo over a longer period of time will help elucidate the full potential of povidone-iodine ointment and liposomal hydrogel.
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28
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Percival SL, Suleman L. Slough and biofilm: removal of barriers to wound healing by desloughing. J Wound Care 2016; 24:498, 500-3, 506-10. [PMID: 26551642 DOI: 10.12968/jowc.2015.24.11.498] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The presence of non-viable tissue in a chronic wound presents a barrier against effective wound healing, hence removal facilitates healing and reduces areas where microorganisms can attach and form biofilms, effectively reducing the risk of infection. Wound debridement is a necessary process in those wounds that have evidence of cellular debris and non-viable tissue. As slough is a form of non-viable tissue we hypothesise that it will support the attachment and development of biofilms. Biofilms are entities that have serious implications in raising the risk of infection and delaying wound healing. In those wounds that contain only slough, high-risk debridement methods are not considered necessary for its removal. The use of mechanical techniques for removing the slough is regarded as posing a much lower risk to the patient and the wound bed. The process of removing slough from a wound is referred to as 'desloughing'. We propose that mechanical desloughing is a low-risk method of debridement to aid the specific removal of slough. Slough in a wound is a recurrent issue for a large majority of patients. Consequently, desloughing should not be deemed a one-off process but an on-going procedure referred to as 'maintenance desloughing'. Maintenance desloughing will help to achieve and maintain a healthy wound bed and aid the removal of wound biofilms, facilitating wound healing.
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Affiliation(s)
- S L Percival
- 5D Health Protection Group Ltd, Biohub, Alderley Park, Alderley Edge, Cheshire, SK10 4TG, UK.,Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - L Suleman
- 5D Health Protection Group Ltd, Biohub, Alderley Park, Alderley Edge, Cheshire, SK10 4TG, UK.,Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
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29
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Scalise A, Bianchi A, Tartaglione C, Bolletta E, Pierangeli M, Torresetti M, Marazzi M, Di Benedetto G. Microenvironment and microbiology of skin wounds: the role of bacterial biofilms and related factors. Semin Vasc Surg 2016; 28:151-9. [PMID: 27113281 DOI: 10.1053/j.semvascsurg.2016.01.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Wound healing is a systemic response to injury that impacts the entire body and not just the site of tissue damage; it represents one of the most complex biological processes. Our knowledge of wound healing continues to evolve and it is now clear that the wound microenvironment plays a crucial role. The interactions between cells and the surface microenvironment, referred to as the "biofilm," contributes to skin homeostasis and healing. Understanding the functional complexity of the wound microenvironment informs how various factors such as age, ischemia, or bacterial infections can impair or arrest the normal healing processes, and it also allows for the possibility of acting therapeutically on healing defects with microenvironment manipulation. Microbes represent a particularly important factor for influencing the wound microenvironment and therefore wound healing. Moreover, the role of infections, particularly those that are sustained by biofilm-forming bacteria, is mutually related to other microenvironment aspects, such as humidity, pH, metalloproteinases, and reactive oxygen species, on which the modern research of new therapeutic strategies is focused. Today, chronic wounds are a rapidly growing health care burden and it is progressively understood that many non-healing wounds might benefit from therapies that target microorganisms and their biofilm communities. There is no doubt that host factors like perfusion impairments, venous insufficiency, pressure issues, malnutrition, and comorbidities strongly impact the healing processes and therefore must be targeted in the therapeutic management, but this approach might be not enough. In this article, we detail how bacterial biofilms and related factors impair wound healing, the reasons they must be considered a treatment target that is as important as the host's local and systemic pathologic conditions, and the latest therapeutic strategies derived from the comprehension of the wound microenvironment.
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Affiliation(s)
- A Scalise
- Department of Plastic and Reconstructive Surgery, Università Politecnica delle, Marche, Ancona, Italy.
| | - A Bianchi
- Department of Plastic and Reconstructive Surgery, Università Politecnica delle, Marche, Ancona, Italy
| | - C Tartaglione
- Department of Plastic and Reconstructive Surgery, Università Politecnica delle, Marche, Ancona, Italy
| | - E Bolletta
- Department of Plastic and Reconstructive Surgery, Università Politecnica delle, Marche, Ancona, Italy
| | - M Pierangeli
- Department of Plastic and Reconstructive Surgery, Università Politecnica delle, Marche, Ancona, Italy
| | - M Torresetti
- Department of Plastic and Reconstructive Surgery, Università Politecnica delle, Marche, Ancona, Italy
| | - M Marazzi
- Struttura Semplice Terapia Tissutale, A.O. Ospedale Niguarda Ca׳ Granda, Milan, Italy
| | - G Di Benedetto
- Department of Plastic and Reconstructive Surgery, Università Politecnica delle, Marche, Ancona, Italy
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30
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Lipsky BA, Aragón-Sánchez J, Diggle M, Embil J, Kono S, Lavery L, Senneville É, Urbančič-Rovan V, Van Asten S, Peters EJG. IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes. Diabetes Metab Res Rev 2016; 32 Suppl 1:45-74. [PMID: 26386266 DOI: 10.1002/dmrr.2699] [Citation(s) in RCA: 334] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Benjamin A Lipsky
- Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- University of Oxford, Oxford, UK
| | | | - Mathew Diggle
- Nottingham University Hospitals Trust, Nottingham, UK
| | - John Embil
- University of Manitoba, Winnipeg, MB, Canada
| | - Shigeo Kono
- WHO-collaborating Centre for Diabetes, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Lawrence Lavery
- University of Texas Southwestern Medical Center and Parkland Hospital, Dallas, TX, USA
| | | | | | - Suzanne Van Asten
- University of Texas Southwestern Medical Center and Parkland Hospital, Dallas, TX, USA
- VU University Medical Centre, Amsterdam, The Netherlands
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31
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Kruse CR, Nuutila K, Lee CCY, Kiwanuka E, Singh M, Caterson EJ, Eriksson E, Sørensen JA. The external microenvironment of healing skin wounds. Wound Repair Regen 2015; 23:456-64. [PMID: 25857996 DOI: 10.1111/wrr.12303] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/02/2015] [Indexed: 11/28/2022]
Abstract
The skin wound microenvironment can be divided into two main components that influence healing: the external wound microenvironment, which is outside the wound surface; and the internal wound microenvironment, underneath the surface, to which the cells within the wound are exposed. Treatment methods that directly alter the features of the external wound microenvironment indirectly affect the internal wound microenvironment due to the exchange between the two compartments. In this review, we focus on the effects of temperature, pressure (positive and negative), hydration, gases (oxygen and carbon dioxide), pH, and anti-microbial treatment on the wound. These factors are well described in the literature and can be modified with treatment methods available in the clinic. Understanding the roles of these factors in wound pathophysiology is of central importance in wound treatment.
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Affiliation(s)
- Carla R Kruse
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark
| | - Kristo Nuutila
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cameron C Y Lee
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth Kiwanuka
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mansher Singh
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Edward J Caterson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elof Eriksson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jens A Sørensen
- Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark
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32
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Percival SL, Vuotto C, Donelli G, Lipsky BA. Biofilms and Wounds: An Identification Algorithm and Potential Treatment Options. Adv Wound Care (New Rochelle) 2015; 4:389-397. [PMID: 26155381 DOI: 10.1089/wound.2014.0574] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 08/04/2014] [Indexed: 01/22/2023] Open
Abstract
Significance: The presence of a "pathogenic" or "highly virulent" biofilm is a fundamental risk factor that prevents a chronic wound from healing and increases the risk of the wound becoming clinically infected. There is presently no unequivocal gold standard method available for clinicians to confirm the presence of biofilms in a wound. Thus, to help support clinician practice, we devised an algorithm intended to demonstrate evidence of the presence of a biofilm in a wound to assist with wound management. Recent Advances: A variety of histological and microscopic methods applied to tissue biopsies are currently the most informative techniques available for demonstrating the presence of generic (not classified as pathogenic or commensal) biofilms and the effect they are having in promoting inflammation and downregulating cellular functions. Critical Issues: Even as we rely on microscopic techniques to visualize biofilms, they are entities which are patchy and dispersed rather than confluent, particularly on biotic surfaces. Consequently, detection of biofilms by microscopic techniques alone can lead to frequent false-negative results. Furthermore, visual identification using the naked eye of a pathogenic biofilm on a macroscopic level on the wound will not be possible, unlike with biofilms on abiotic surfaces. Future Direction: Lacking specific biomarkers to demonstrate microscopic, nonconfluent, virulent biofilms in wounds, the present focus on biofilm research should be placed on changing clinical practice. This is best done by utilizing an anti-biofilm toolbox approach, rather than speculating on unscientific approaches to identifying biofilms, with or without staining, in wounds with the naked eye. The approach to controlling biofilm should include initial wound cleansing, periodic debridement, followed by the application of appropriate antimicrobial wound dressings. This approach appears to be effective in removing pathogenic biofilms.
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Affiliation(s)
- Steven L. Percival
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
- Surface Science Research Centre, University of Liverpool, Liverpool, United Kingdom
- Scapa Healthcare, Manchester, United Kingdom
| | - Claudia Vuotto
- Microbial Biofilm Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | - Benjamin A. Lipsky
- Division of Medical Sciences, University of Oxford, Oxford, United Kingdom
- Department of Medicine (Infectious Diseases) University of Geneva, Geneva, Switzerland
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33
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Mota VDS, Turrini RNT, Poveda VDB. Antimicrobial activity of Eucalyptus globulus oil, xylitol and papain: a pilot study. Rev Esc Enferm USP 2015; 49:216-20. [DOI: 10.1590/s0080-623420150000200005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 12/04/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the in vitro antimicrobial activity of the Eucalyptus globulus essential oil, and of the xylitol and papain substances against the following microorganisms: Pseudomonas aeruginosa; Samonella sp.; Staphylococus aureus; Proteus vulgaris; Escherichia coli and Candida albicans. METHOD The in vitro antimicrobial evaluation was used by means of the agar diffusion test and evaluation of the inhibition zone diameter of the tested substances. Chlorhexidine 0.5% was used as control. RESULTS The Eucalyptus globulus oil showed higher inhibition than chlorhexidine when applied to Staphylococcus aureus, and equal inhibition when applied to the following microorganisms: Escherichia coli, Proteus vulgaris and Candida albicans. Papain 10% showed lower antimicrobial effect than chlorhexidine in relation to Candida albicans. Xylitol showed no inhibition of the tested microorganisms. CONCLUSION The Eucalyptus globulus oil has antimicrobial activity against different microorganisms and appears to be a viable alternative as germicidal agent hence, further investigation is recommended.
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34
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Armstrong DG, Lew EJ, Hurwitz B, Wild T. The quest for tissue repair's holy grail: The promise of wound diagnostics or just another fishing expedition? ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.wndm.2015.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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