Cetylpyridinium Chloride-Containing Mouthwashes Show Virucidal Activity against Herpes Simplex Virus Type 1

An exploratory study of drug concentration and inhibitory effect of cetylpyridinium chloride buccal tablets on SARS-CoV-2 infection among 10 Chinese subjects

BACKGROUND

It was evidenced that cetylpyridinium-chloride (CPC) mouthwash could inhibit SARS-COV-2 activity and reduce salivary viral load, thus reducing SARS-CoV-2 transmission. However, due to insufficient residence time in the oral cavity, CPC-containing mouthwashes have no prolonged antiviral effect. The duration of action of the CPC buccal tablet is expected to be longer than that of the mouthwash. However, there are currently no reports on the salivary drug concentration of CPC buccal tablets.

OBJECTIVE

The study aimed to investigate the salivary drug concentration of CPC buccal tablets and the antiviral effect of CPC on SARS-CoV-2 in vitro.

TRIAL DESIGN

This is a single-dose, single-arm clinical trial, involving 10 Chinese healthy subjects who received 2-mg CPC buccal tablet to collect saliva samples and to detect saliva concentration at different timepoints within 2 h (Clinical Trial Registration Number: NCT05802628, Registration Date: April 6, 2023).

MATERIALS AND METHODS

CPC concentration in saliva was detected by liquid chromatography tandem mass spectrometry (LC-MS/MS), and pharmacokinetic parameters were calculated based on the non-compartmental model. With an in vitro antiviral experiment, the activity of CPC buccal tablets against SARS-CoV-2 and its cellular toxicity was tested.

RESULTS

Drug concentrations in saliva at 15 min, 30 min, 1 h, 1.5 h, and 2 h after administration were 8008.33 (1042.25, 41081.11), 2093.34 (373.15, 5759.83), 1016.58 (378.66, 3480.68), 891.77 (375.66, 6322.07), and 717.43 (197.87, 2152.71) ng/mL. PK parameters of saliva concentration: Cmax = 8008.33 (1042.25, 41081.11) ng/mL, AUC0-t = 4172.37 (904.42, 13912.61) ng/mL * h, AUC0-∞ = 6712.85 (1856.77, 19971.12) ng/mL * h, T1/2 = 1.22 (0.59, 2.83) h, Tmax = 0.25 (0.25, 0.25) h. As determined in in vitro experiment, CPC was active on SARS-CoV-2 with cytotoxic and inhibitory activity of CC50 = 35.75 μM (≈12155 ng/mL) and EC50 = 7.39 μM (≈2512.6 ng/mL).

CONCLUSIONS

The comparison between the salivary CPC concentration and EC50/CC50 values from in vitro antiviral experiments suggests that CPC buccal tablets may inhibit SARS-CoV-2 activity, and the inhibition may last for approximately 30 min without cytotoxicity.

Influence of Five Different Commercially Available Mouthwashes on the Growth of Candida albicans Adhered to Customized Prefabricated Heat-Cured Denture Base Acrylic Resin Sheets: An In Vitro Study

Background The purpose of this in vitro investigation was to evaluate the impact of five distinct commercial mouthwashes on the development of Candida albicans that had been adhered to heat-cured acrylic resin sheets. Methods This in vitro investigation was carried out at the MES Medical College's Microbiology Department in Perinthalmanna, Kerala, India. A total of 72 heat-cured acrylic resin sheets, size 10 × 10 × 2 mm, were fabricated. After disinfection, all 72 acrylic sheets were placed in a flask containing a suspension of the standard strain of Candida species (American Type Culture Collection) and incubated at 37ºC for 24 hours. Then, the acrylic sheets were randomly divided into six groups, with each group containing 12 acrylic sheets. Group 1 was the control group to which no mouthwash was added. In group 2, Colgate Plax was added. In group 3, Hiora Himalaya was added. In group 4, Oral B was added. In group 5, Listerine was added. In group 6, Pepsodent was added. Colony-forming units (CFUs) were assessed using a colony counter every six, 24, 48, and 120 hours. After obtaining the pH and CFU of all 72 specimens, software known as the Statistical Package for Social Sciences (SPSS) (IBM Corp., Armonk, NY) was used to analyze the data. Results Candida albicans adhered to heat-cured denture base acrylic resin sheets differed significantly in response to commercially available mouthwashes (Oral B, Colgate Plax, and Pepsodent) and non-commercial mouthwashes (Hiora Himalaya and Listerine) that contained cetylpyridinium chloride. Conclusions Compared to other mouthwashes that do not contain cetylpyridinium chloride (Listerine and Hiora Himalaya), mouthwashes with cetylpyridinium chloride as the active ingredient (Oral B, Pepsodent, and Colgate Plax) have shown good antifungal properties against the adhering Candida albicans on denture base resin.

Cetylpyridinium chloride and chlorhexidine show antiviral activity against Influenza A virus and Respiratory Syncytial virus in vitro

BACKGROUND

The oral cavity is the site of entry and replication for many respiratory viruses. Furthermore, it is the source of droplets and aerosols that facilitate viral transmission. It is thought that appropriate oral hygiene that alters viral infectivity might reduce the spread of respiratory viruses and contribute to infection control.

MATERIALS AND METHODS

Here, we analyzed the antiviral activity of cetylpyridinium chloride (CPC), chlorhexidine (CHX), and three commercial CPC and CHX-containing mouthwash preparations against the Influenza A virus and the Respiratory syncytial virus. To do so the aforementioned compounds and preparations were incubated with the Influenza A virus or with the Respiratory syncytial virus. Next, we analyzed the viability of the treated viral particles.

RESULTS

Our results indicate that CPC and CHX decrease the infectivity of both the Influenza A virus and the Respiratory Syncytial virus in vitro between 90 and 99.9% depending on the concentration. Likewise, CPC and CHX-containing mouthwash preparations were up to 99.99% effective in decreasing the viral viability of both the Influenza A virus and the Respiratory syncytial virus in vitro.

CONCLUSION

The use of a mouthwash containing CPC or CHX alone or in combination might represent a cost-effective measure to limit infection and spread of enveloped respiratory viruses infecting the oral cavity, aiding in reducing viral transmission. Our findings may stimulate future clinical studies to evaluate the effects of CPC and CHX in reducing viral respiratory transmissions.