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Plata JC, Díaz-Báez D, Delgadillo NA, Castillo DM, Castillo Y, Hurtado CP, Neuta Y, Calderón JL, Lafaurie GI. Hypochlorous Acid as a Potential Postsurgical Antimicrobial Agent in Periodontitis: A Randomized, Controlled, Non-Inferiority Trial. Antibiotics (Basel) 2023; 12:1311. [PMID: 37627732 PMCID: PMC10451621 DOI: 10.3390/antibiotics12081311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Hypochlorous acid (HOCl) is an antimicrobial agent with high affinity to Gram-negative bacteria of the subgingival biofilm. It could have an equivalent or no inferiority effect to chlorhexidine (CHX) to avoid recolonization of these microorganisms after the post-surgical period. OBJECTIVE The objective is to compare the reduction of plaque index (PI), gingival index (GI), pocket depth (PD), gain of clinical attachment level (CAL), and bacterial recolonization of periodontopathic microorganisms in subgingival biofilm at 7, 21, and 90 days after Open Flap Debridement (OFD) under two antimicrobial protocols: (A) HOCl 0.05% followed by HOCl 0.025% and (B) CHX 0.2%/CHX 0.12% used per 21 days without regular oral hygiene during the post-surgical period. MATERIAL AND METHODS A no-inferiority randomized controlled trial was carried out. Thirty-two patients were randomly divided to receive each antiplaque protocol after OFD in patients with periodontitis. Clinical indexes and bacterial recolonization were assessed using qPCR for up to 90 days. Data were analyzed using repeated measures ANOVA, mixed effects models adjusted for treatment, time, and the Chi-squared/Fisher test. A no-inferiority analysis was also performed using the Hodges-Lehmann hypothesis test for non-inferiority. RESULTS HOCl was not inferior to CHX in reducing PI. Both groups showed a comparable reduction of recolonization for Porphyromonas gingivalis, Tannerella forsythia, and Eubacterium nodatum. However, the HOCl protocol was non-inferior to the CHX protocol for Treponema denticola and Aggregatibacter actinomicetemcomitans. CONCLUSIONS HOCl improved periodontal healing. HOCl showed an impact in reducing the recolonization of periodontopathic bacteria in the postoperative period.
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Affiliation(s)
- Julio Cesar Plata
- Master’s Program in Dental Sciences, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia;
- School of Dentistry, Universidad Cooperativa de Colombia, Bucaramanga P.O. Box 680001, Colombia;
| | - David Díaz-Báez
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Nathaly Andrea Delgadillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Diana Marcela Castillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Yormaris Castillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Claudia Patricia Hurtado
- School of Dentistry, Universidad Cooperativa de Colombia, Bucaramanga P.O. Box 680001, Colombia;
| | - Yineth Neuta
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Justo Leonardo Calderón
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Gloria Inés Lafaurie
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
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Ekmekciu I, von Klitzing E, Fiebiger U, Escher U, Neumann C, Bacher P, Scheffold A, Kühl AA, Bereswill S, Heimesaat MM. Immune Responses to Broad-Spectrum Antibiotic Treatment and Fecal Microbiota Transplantation in Mice. Front Immunol 2017; 8:397. [PMID: 28469619 PMCID: PMC5395657 DOI: 10.3389/fimmu.2017.00397] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/21/2017] [Indexed: 12/12/2022] Open
Abstract
Compelling evidence demonstrates the pivotal role of the commensal intestinal microbiota in host physiology and the detrimental effects of its perturbations following antibiotic treatment. Aim of this study was to investigate the impact of antibiotics induced depletion and subsequent restoration of the intestinal microbiota composition on the murine mucosal and systemic immunity. To address this, conventional C57BL/6j mice were subjected to broad-spectrum antibiotic treatment for 8 weeks. Restoration of the intestinal microbiota by peroral fecal microbiota transplantation (FMT) led to reestablishment of small intestinal CD4+, CD8+, and B220+ as well as of colonic CD4+ cell numbers as early as 7 days post-FMT. However, at d28 following FMT, colonic CD4+ and B220+ cell numbers were comparable to those in secondary abiotic (ABx) mice. Remarkably, CD8+ cell numbers were reduced in the colon upon antibiotic treatment, and FMT was not sufficient to restore this immune cell subset. Furthermore, absence of gut microbial stimuli resulted in decreased percentages of memory/effector T cells, regulatory T cells, and activated dendritic cells in the small intestine, colon, mesenteric lymph nodes (MLN), and spleen. Concurrent antibiotic treatment caused decreased cytokine production (IFN-γ, IL-17, IL-22, and IL-10) of CD4+ cells in respective compartments. These effects were, however, completely restored upon FMT. In summary, broad-spectrum antibiotic treatment resulted in profound local (i.e., small and large intestinal), peripheral (i.e., MLN), and systemic (i.e., splenic) changes in the immune cell repertoire that could, at least in part, be restored upon FMT. Further studies need to unravel the distinct molecular mechanisms underlying microbiota-driven changes in immune homeostasis subsequently providing novel therapeutic or even preventive approaches in human immunopathologies.
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Affiliation(s)
- Ira Ekmekciu
- Department of Microbiology and Hygiene, Charité - University Medicine Berlin, Berlin, Germany
| | - Eliane von Klitzing
- Department of Microbiology and Hygiene, Charité - University Medicine Berlin, Berlin, Germany
| | - Ulrike Fiebiger
- Department of Microbiology and Hygiene, Charité - University Medicine Berlin, Berlin, Germany
| | - Ulrike Escher
- Department of Microbiology and Hygiene, Charité - University Medicine Berlin, Berlin, Germany
| | - Christian Neumann
- Department of Cellular Immunology, Clinic for Rheumatology and Clinical Immunology, Charité - University Medicine Berlin, Berlin, Germany.,German Rheumatism Research Center (DRFZ), Leibniz Association, Berlin, Germany
| | - Petra Bacher
- Department of Cellular Immunology, Clinic for Rheumatology and Clinical Immunology, Charité - University Medicine Berlin, Berlin, Germany
| | - Alexander Scheffold
- Department of Cellular Immunology, Clinic for Rheumatology and Clinical Immunology, Charité - University Medicine Berlin, Berlin, Germany.,German Rheumatism Research Center (DRFZ), Leibniz Association, Berlin, Germany
| | - Anja A Kühl
- Department of Medicine I for Gastroenterology, Infectious Diseases and Rheumatology, Research Center ImmunoSciences (RCIS), Charité - University Medicine Berlin, Berlin, Germany
| | - Stefan Bereswill
- Department of Microbiology and Hygiene, Charité - University Medicine Berlin, Berlin, Germany
| | - Markus M Heimesaat
- Department of Microbiology and Hygiene, Charité - University Medicine Berlin, Berlin, Germany
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