Topical Application of Ozonated Oils for the Treatment of MRSA Skin Infection in an Animal Model of Infected Ulcer

Successful treatment of severe and recurrent hand eczema with infection in human immunodeficiency virus patients: A case report

Hand eczema is a common allergic disease characterized by a chronic relapsing course with a 15% lifetime prevalence. Human immunodeficiency virus-infected individuals have a higher risk of Staphylococcus aureus infection which is associated with the severity of hand eczema. Incidences of allergic diseases including hand eczema and chronic itch are higher in patients with human immunodeficiency virus. Pruritus is one of the most common symptoms in hand eczema, sometimes intractable pruritus provokes repeated scratching, picking, disfigurement, and can even worsen the lesion. Currently, there is no ideal treatment for hand eczema, the treatment of hand eczema in human immunodeficiency virus patients is even more difficult. Here, we present a case of recurrent and therapy-resistant hand eczema patients combined with Staphylococcus aureus infection, human immunodeficiency virus infection was better improved by being treated with topical ozone therapy.

Nonconventional Technologies in Lipid Modifications

Lipid modifications play a crucial role in various fields, including food science, pharmaceuticals, and biofuel production. Traditional methods for lipid modifications involve physical and chemical approaches or enzymatic reactions, which often have limitations in terms of specificity, efficiency, and environmental impact. In recent years, nonconventional technologies have emerged as promising alternatives for lipid modifications. This review provides a comprehensive overview of nonconventional technologies for lipid modifications, including high-pressure processing, pulsed electric fields, ultrasound, ozonation, and cold plasma technology. The principles,mechanisms, and advantages of these technologies are discussed, along with their applications in lipid modification processes. Additionally, the challenges and future perspectives of nonconventional technologies in lipid modifications are addressed, highlighting the potential and challenges for further advancements in this field. The integration of nonconventional technologies with traditional methods has the potential to revolutionize lipid modifications, enabling the development of novel lipid-based products with enhanced functional properties and improved sustainability profiles.

A Comparative Study of the Chemical Properties and Antibacterial Activity of Four Different Ozonated Oils for Veterinary Purposes

Infectious skin diseases are quite common in veterinary medicine. These diseases can be caused by both bacteria and pathogenic fungi. Antimicrobial drugs are usually used for treatment. An alternative to these drugs could be ozonated oils with antibacterial and antifungal properties. Four different ozonated oils (linseed, hemp seed, sunflower, and olive) were tested in order to develop an optimal pharmaceutical form for the treatment of skin infections in animals. Chemical parameters such as acid and acidity value, iodine and peroxide value, viscosity, and infrared spectres were analysed. The ozonation of oils resulted in changes in their chemical composition. The antimicrobial activity of the tested oils was evaluated by determining the minimum inhibitory concentrations and zones of inhibition in agar. After ozonation, the acid content increased in all the tested oils. The highest acidity was found in linseed oil (13.00 ± 0.11 mg KOH/g; 6.1%). Hemp oil, whose acidity was also significant (second only to linseed oil), was the least acidified by ozonation (11.45 ± 0.09 mg KOH/g; 5.75%). After ozonation, the iodine value in oils was significantly reduced (45-93%), and the highest amounts of iodine value remained in linseed (47.50 ± 11.94 g Iodine/100 g oil) and hemp (44.77 ± 1.41 Iodine/100 g oil) oils. The highest number of peroxides after the ozonation of oils was found in sunflower oil (382 ± 9.8 meqO2/kg). It was found that ozonated hemp and linseed oils do not solidify and remain in liquid form when the temperature drops. The results showed a tendency for the reference strains of S. aureus, E. faecalis, and E. coli to have broader zones of inhibition (p < 0.001) than clinical strains. Overall, ozonated linseed oil had the highest antibacterial activity, and ozonated olive oil had the lowest, as determined by both methods. It was found that ozonated linseed oil was the most effective on bacteria, while the most sensitive were S. aureus ATCC 25923, MRSA, and S. pseudointermedius (MIC 13.5 mg/mL, 4.6 mg/mL, and 13.5 mg/mL, respectively, and sterile zones 20.67 ± 0.98 mm, 20.25 ± 0.45 mm, and 18.25 ± 0.45 mm, respectively). The aim and new aspect of this work is the characterisation of selected ozonated vegetable oils, especially hemp oil, according to chemical and antibacterial parameters, in order to select suitable candidates for preclinical and clinical animal studies in the treatment of bacterial or fungal skin infections in terms of safety and efficacy.

Physico-Chemical Investigation and Antimicrobial Efficacy of Ozonated Oils: The Case Study of Commercial Ozonated Olive and Sunflower Seed Refined Oils

Drug resistance represents one of the great plagues of our time worldwide. This largely limits the treatment of common infections and requires the development of new antibiotics or other alternative approaches. Noteworthy, the indiscriminate use of antibiotics is mostly responsible for the selection of mutations that confer drug resistance to microbes. In this regard, recently, ozone has been raising interest for its unique biological properties when dissolved in natural oils. Ozonated oils have been reported to act in a non-specific way on microorganisms hindering the acquisition of advantageous mutations that result in resistance. Here, we focused on the antimicrobial effect of two commercial olive (OOO) and sunflower seeds (OSO) oils. Nuclear magnetic resonance spectroscopy and thermal analysis showed the change in the chemical composition of the oils after ozonation treatment. Different ozonated oil concentrations were then used to evaluate their antimicrobial profile against Candida albicans, Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli by agar diffusion and broth dilution methods. Cytotoxicity was also evaluated in keratinocytes and epithelial cells. Overall, our results revealed that both OOO and OSO showed a potent microbicidal effect, especially against C. albicans (IC50 = OOO: 0.3 mg/mL and OSO: 0.2 mg/mL) and E. faecalis (IC50 = OOO: 0.4 mg/mL and OSO: 2.8 mg/mL) albeit exerting a certain effect also against S. aureus and E. coli. Moreover, both OOO and OSO do not yield any relevant cytotoxic effect at the active concentrations in both cell lines. This indicates that the ozonated oils studied are not toxic for mammalian cells despite exerting a potent antimicrobial effect on specific microorganisms. Therefore, OOO and OSO may be considered to integrate standard therapies in the treatment of common infections, likely overcoming drug resistance issues.

The Oxygen-Ozone Adjunct Medical Treatment According to the Protocols from the Italian Scientific Society of Oxygen-Ozone Therapy: How Ozone Applications in the Blood Can Influence Clinical Therapy Success via the Modulation of Cell Biology and Immunity

BACKGROUND

Ozone is an allotrope of oxygen whose use in medicine has rapidly grown in recent years. Ozonated blood allows for the use of ozone in a safe modality, as plasma and blood cells are endowed with an antioxidant system able to quench ozone's pro-oxidant property and to elicit the Nrf2/Kwap1/ARE pathway.

METHODS

We present two clinical studies, a case-series (six patients) observational study adopting ozone as a major autohemotherapy and topical ozone to address infected post-surgical wounds with multi-drug resistant bacteria and an observational study (250 patients) using ozonated blood for treating knee osteoarthritis.

RESULTS

Ozonated blood via major autohemotherapy reduced the extent of infections in wounds, reduced the inflammatory biomarkers by more than 75% and improved patients' QoL, whereas ozonated blood via minor autohemotherapy improved significantly (p < 0.001) WOMAC and Lequesne's parameters in knee osteoarthritis.

CONCLUSIONS

The models described, i.e., ozone autohemotherapy in wound antimicrobial treatment and ozonated blood in knee osteoarthrosis, following our protocols, share the outstanding ability of ozone to modulate the innate immune response and address bacterial clearance as well as inflammation and pain.

Cell Therapy and Investigation of the Angiogenesis of Fibroblasts with Collagen Hydrogel on the Healing of Diabetic Wounds

Objectives

A diabetic ulcer is a common disease in patients with diabetes. Because of antibiotic resistance, new therapeutic alternatives are being considered in diabetic foot patients to reduce complications and mortality. This study aimed to evaluate the effect of collagen hydrogel on the wound-healing process in diabetic rats.

Materials and Methods

Diabetic wounds were induced with streptozotocin in all 42 male Wistar rats. The rats were divided into four groups: (a) treated with fibroblast cells, (b) collagen hydrogel, (c) collagen cultured with fibroblast cells, and (d) a control group. Microscopic and histological (hematoxylin and eosin staining and Mason trichrome staining), measurement of wound surface with image J, skin density and thickness by the ultrasound probe, and skin elasticity with cytometer tool were used to evaluate wound healing at days 14 and 21 after the treatment.

Results

The results showed that treating diabetic wounds with fibroblasts cultured in collagen hydrogel greatly reduces inflammatory responses in the skin tissue and significantly accelerates the healing process. In addition, 21 days after the start of treatment, skin elasticity, thickness, and density were higher in the collagen + fibroblast group than in the control group.

Conclusion

In addition, the results of the present study show that diabetic wound dressing can significantly reduce the inflammatory phase in the wound healing process by increasing the speed of collagen synthesis, skin density and elasticity, and angiogenesis.

Microbially Synthesized Polymer-Metal Nanoparticles Composites as Promising Wound Dressings to Overcome Methicillin-Resistance Staphylococcus aureus Infections

Antimicrobial resistance has been declared one of the top 10 global public health threats. Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of recurring skin and soft tissue infections in patients with chronic skin conditions such as diabetic foot infections, making the treatment of the ulcers challenging. Wound dressings combined with metal nanoparticles have been suggested to prevent and treat MRSA-infected wounds. However, these particles are commonly synthesized by chemical approaches. In this study, we developed bio-based silver (Bio-AgNPs) and copper oxide nanoparticles (CuONPs) polymer composites using a microbially produced polyester from the Polyhydroxyalkanoates (PHAs) family. Poly(3-hydroxyoctanoate)-co-(3-hydroxyhexanoate) (PHO) was synthesized by Pseudomonas putida and functionalized in-situ with Bio-AgNPs or ex-situ with CuONPs. PHO-CuONPs films did not inhibit MRSA growth, while a reduction of 6.0 log CFU/mL was achieved with PHO-Bio-AgNPs synthesized from silver nitrate (AgNO₃) solution at 3.5 mM. Exposure of human fibroblast cells (HFF-1) to the bioactive films did not induce notable cytotoxicity and genotoxicity, as seen by a viability higher than 79% and no significant changes in basal DNA damage. However, exposure to PHO-Bio-AgNPs induced oxidative DNA damage in HFF-1 cells. No hemolytic potential was observed, while platelet aggregation was promoted and desired for wound healing. Here we demonstrate the biosynthesis of polymer-nanoparticle composites and their potential as bioactive films for MRSA treatment.

An optimized mouse model of Staphylococcus aureus infected diabetic ulcers

OBJECTIVE

Diabetic foot infection (DFI) represents a major healthcare burden, for which treatment is challenging owing to the pathophysiological alterations intrinsic to diabetes and the alarming increase of antimicrobial resistance. Novel therapies targeting DFI are therefore a pressing research need for which proper models of disease are required.

RESULTS

Here, we present an optimized diabetic mouse model of methicillin-resistant Staphylococcus aureus (MRSA)-infected wounds, that resemble key features of DFI, such as pathogen invasion through wound bed and surrounding tissue, necrosis, persistent inflammation and impaired wound healing. Thus, in a time-efficient manner and using simple techniques, this model represents a suitable approach for studying emerging therapies targeting DFI caused by MRSA.

Management of Periodontal Disease with Adjunctive Therapy with Ozone and Photobiomodulation (PBM): A Randomized Clinical Trial

Periodontitis is an inflammatory condition of the soft and hard tooth-supporting tissues, representing the first cause of tooth loss. In addition to standard mechanical debridement (Scaling and Root Planing, SRP), further approaches have been proposed as adjuncts. The aim of the present randomized clinical trial is to compare the efficacy of ozone or photobiomodulation (PBM) therapy in addition to SRP to treat periodontal disease. According to a split-mouth design, 240 pathological sites, corresponding to 30 periodontal patients, were randomly divided according to the professional oral hygiene protocol performed at baseline (T0) and after 1 (T1), 2 (T2), 3 (T3), 4 (T4), 5 (T5), and 6 (T6) months. A total of 120 sites underwent an ozonized water administration (ozone group), whereas the other 120 sites were treated with photobiomodulation (PBM group), both in addition to SRP. At every timepoint, the following clinical indexes were assessed: Probing Pocket Depth (PPD) (measured on six sites per element), Plaque Index (PI), and Bleeding on Probing (BOP). As regards PPD, significant intergroup differences were noticed from T5, with significantly lower values in the PBM group (p < 0.05), where values further decreased at T6 (p < 0.05). Both PI and BoP generally decreased from baseline to T6 in both groups; a significant difference was found between T0 and T1 among the groups (p < 0.05), with a progressively higher reduction in the PBM group among the time frames of the study, despite intergroup comparisons not being significant (p > 0.05). Both ozone and PBM appear to be effective adjuvant treatments to SRP, obtaining a slightly better outcome for the latter in the long term, with significant differences at T5 and T6 for PPD. However, because of the absence of standardized protocols for PBM considering both therapeutic and research purposes, no definitive conclusions can be reached, and further studies are required.

Ozonized Water Administration in Peri-Implant Mucositis Sites: A Randomized Clinical Trial

Peri-implant mucositis represents an inflammatory lesion of the mucosa surrounding an endosseous implant, without the loss of the supporting peri-implant bone. Considering its reversible nature, every effort should be made to contrast it, thus avoiding the eventual progression towards peri-implantitis. The aim of the present randomized clinical trial is to evaluate the efficacy of the ozonized water against peri-implant mucositis. A total of 26 patients diagnosed for this latter clinical condition were randomly divided according to the professional oral hygiene protocol performed on the pathological sites at baseline, at T1 (1 month), and T2 (2 months). Group 1 underwent an ozonized water administration (experimental treatment), whereas Group 2 underwent a pure water one (control treatment). Both administrations were performed with the same professional irrigator (Aquolab® professional water jet, Aquolab s.r.l. EB2C S.r.l., Milano, Italy) with no differences in color or taste between the two substances delivered. At each appointment, the following indexes were assessed: the Probing Pocket Depth (PPD), Plaque Index (PI), Bleeding on Probing (BoP), and Bleeding Score (BS). As regards intragroup differences, in Group 1 ozonized water significantly and progressively reduced all the clinical indexes tested, except for PI in the period T1–T2, whereas no significant differences occurred within the control group. Despite this, no significant intergroup differences were generally detected between the two treatments. Accordingly, the role of ozone for the management of peri-implant mucositis deserves to be further investigated.

Ozonized Water in Microbial Control: Analysis of the Stability, In Vitro Biocidal Potential, and Cytotoxicity

O3 dissolved in water (or ozonized water) has been considered a potent antimicrobial agent, and this study aimed to test this through microbiological and in vitro assays. The stability of O3 was accessed following modifications of the physicochemical parameters of water, such as the temperature and pH, with or without buffering. Three concentrations of O3 (0.4, 0.6, and 0.8 ppm) dissolved in water were tested against different microorganisms, and an analysis of the cytotoxic effects was also conducted using the human ear fibroblast cell line (Hfib). Under the physicochemical conditions of 4 °C and pH 5, O3 remained the most stable and concentrated compared to pH 7 and water at 25 °C. Exposure to ozonized water resulted in high mortality rates for Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis, and Candida albicans. Scanning electron micrograph images indicate that the effects on osmotic stability due to cell wall lysis might be one of the killing mechanisms of ozonized water. The biocidal agent was biocompatible and presented no cytotoxic effect against Hfib cells. Therefore, due to its cytocompatibility and biocidal action, ozonized water can be considered a viable alternative for microbial control, being possible, for example, its use in disinfection processes.