CSP0510 Lotion as a Novel Moisturizer Containing Citric Acid and Trisodium Phosphate Relieves Objective and Subjective Symptoms of Atopic Dermatitis

BACKGROUND: Moisturizers with anti-inflammatory or anti-itch activity should be developed for the safe and effective management of atopic dermatitis (AD). OBJECTIVE: This study evaluated the efficacy of a newly developed moisturizer, CSP0510 lotion (Twolines Inc., Korea), containing citric acid (CA) and trisodium phosphate (TSP) as active ingredients, in mild to moderate AD. METHODS AND RESULTS: CSP0510 lotion applied twice daily for 4 weeks to eczematous lesions improved objective and subjective (itch) symptoms of AD. The physician's global assessment (PGA) score for objective symptoms decreased from 2.5±0.6 before application to 1.3±0.5 after application in the CSP0510-treated group (n=42, p<0.001). Also, the PGA score decreased from 2.3±0.6 to 1.9±0.5 by vehicle-treated (without CA and TSP) control group (p=0.001), but there was no statistical difference between CSP0510-treated and vehicle-treated groups (p=0.089). The visual analogue scale score for itch decreased from 4.8±1.3 to 2.0±0.9 in the CSP0510-treated group (p<0.001), and from 4.6±1.1 to 3.5±0.9 in the control group (p=0.075), showing a statistical significance between two groups (p=0.002). Our results in humans were further supported by in vitro and animal experiments. In HaCaT cells treated with compound 48/80 (7.5 µg/ml), CA:TSP (1:1, vol:vol) synergistically suppressed the compound 48/80-induced upregulation of thymic stromal lymphopoietin, nerve grow factor, and calcitonin gene-related peptide. Application of CSP0510 to the dorsal skin of hairless mice for 3 weeks suppressed the oxazolone-induced allergic skin inflammation. CONCLUSION: In conclusion, CSP0510 lotion has anti-itch and anti-inflammatory activity in the skin, which improves both objective and subjective symptoms of AD.

The Growth Inhibition Effect on the Bacterial Vaginosis Causative Bacteria by Citric Acid and Trisodium Phosphate

Bacterial vaginosis (BV) is the most frequent vaginal disease being apt to relapse. The growth inhibition effect of the mixture of citric acid (CA) and trisodium phosphate (TSP) on BV causative bacteria and probiotics was measured. Gardnerella vaginalis was reduced to zero in WCCT-1 (CA 0.25% and TSP 0.55% in Wilkins-Chalgren broth), 2.0 x 10(4)/ml in WCCT-2 (CA 0.5% and TSP 0.8% in WC), and 3.3 x 10(3)/ml in WCCT-3 (CA 1.0% and TSP 2.6% in WC) comparing with 1.3 x 10(5)/ml in WC after 48 h. Bacteroides fragilis was reduced to 6.0 x 10(3)/ml in WCCA (CA 0.34% in WC), 2.3 x 10(2)/ml in WCCT (CA 0.5% and TSP 0.2% in WC), 7.0 x 10(3)/ml in WCHCl (HCl in WC) after 48 h. Mobiluncus mulieris was reduced to 1.08 x 10(4)/ml in WCCA, 1.03 x 10(3)/ml in WCCT, and 10 ea/ml in WCHCl after 48 h. Peptostreptococcus asaccharolyticus was completely inhibited in WCCA, WCCT, and WCHCl after 24 h. Probiotics, Steroidobacter denitrificans YH1 (3.4 x 10(7)/ml) and Lactobacillus crispatus YH2 (2.7 x 10(6)/ml), grew to 1.25 x 10(8)/ml and 2.6 x 10(7)/ml in MRSCA (CA 1.0% in MRS), 1.8 x 10(7)/ml and 4.6 x 10(6)/ml in MRSCT (CA 1.5% and TSP 0.58% in MRS), 1.2 x 10(8)/ml and 2.3 x 10(7)/ml in MRSHCl after 48 h, respectively. These results mean that the CA-TSP mixture can be used as the useful vaginal pH controller, growth inhibitor on BV causative bacteria, and an efficient means for settlement of probiotics.

Effects of different methods of decontamination for successful cultivation of Mycobacterium tuberculosis.

Background & objectives: There has been an extensive invasion of tuberculosis at the global level by multidrug resistant as well as extensively drug resistant organisms. Attempts to recover the pathogen in pure culture have frequently failed since the specimens are often highly contaminated and also due to use of insufficient or over-active decontamination procedures. Hence in the present study different methods of decontamination were tested to evaluate their independent efficacies for culture of Mycobacterium tuberculosis. Methods: A total of 359 samples (241 sputum, 59 urine, 50 endometrium biopsy, 9 pus samples) from clinically suspected cases of tuberculosis were subjected to four different methods of decontamination followed by inoculation in Lowenstein-Jensen medium (LJM), and bilayered medium (BLM) and Kirchner’s liquid medium (KLM) to determine the influence of differential decontamination processes. Sputum scanty and positive specimens were graded and each sample was subjected to decontamination by four different techniques. Results: Treatment of specimens with 4 per cent NaOH yielded minimum recovery of pure cultures, while use of 2 per cent NaOH produced higher number of contaminants compared to other methods of decontamination. Addition of N-acetyl L-cystein (NALC) coupled with 2 per cent NaOH to the samples for decontamination provided fairly reasonable recovery, but the highest number of M. tuberculosis cultures could be obtained when the specimens were treated with tri-sodium phosphate and benzalkonium (TSPB). Among the sputum positive cases recovery of growth of M. tuberculosis was higher with greater number of bacilli present in the specimens. Regarding the influence of culture media, BLM produced not only rapid growth, but reasonably higher rate of isolation of M. tuberculosis. Interpretation & conclusions: Although use of TSPB was found to be an efficient method of decontamination for successful isolation of M. tuberculosis from contaminated samples, both NALC+ 2 per cent NaOH and TSPB also showed significant recovery of M. tuberculosis cultures in BLM that can facilitate early diagnosis and initiation of treatment.

Evaluation of trisodium phosphate as a transport medium and its utility in a single-step decontamination technique for the culture of M. tuberculosis.

Background Sputum specimens were received from various out-patient departments of a tertiary care referral hospital to acid-fast staining and mycobacterial culture. Material & Methods A simple, one-step decontamination and concentration method was adopted before subjecting the samples to acid-fast staining and mycobacterial culture. Trisodium phosphate, a cheap, “soft” decontaminant-cum-liquefying agent was used to treat the sputum specimens before Ziehl-Neelsen’s (ZN) acid-fast staining and Lowenstein-Jensen’s (LJ) medium culture. The sputum samples were collected directly into trisodium phosphate containing screw capped McCartney bottles (Day-0). The bottles were vortexed and left overnight at room temperature. On the subsequent morning (Day-1), the supernatants were discarded and smears made from deposits were stained by ZN stain. Results A total of 30 consecutive samples, which showed smear positivity by ZN technique, were selected for the present study. Deposits from these smear positive cases were cultured onto duplicate slants of LJ medium and incubated at 370C (Day-1). Duplicate slants of LJ media were inoculated from each of these preserved deposits on 2nd, 3rd , 4th, 6th and 8th days. Culture bottles were incubated at 370C for 8 weeks and positive growths were recorded. Culture retrieval was possible from 29 (96.7%) samples from deposits of Day –1 to Day-3. The culture positivity , however, had dropped to 26 (86.7%),18 (60%) and 6 (20%) from deposits of Day-4, Day-6 and Day-8, respectively. All the isolates were identified as M. tuberculosis and there was minimal contamination (0.83%). The culture retrieval dropped significantly only after Day-3. Conclusion This method is, therefore, suitable for transportation, preservation and decontamination of sputum samples before staining and culture, up to 3 days after collection. This will be helpful especially for collection of sputum samples from distant places and their transportation to nearest mycobacteriology laboratory as also for sputum samples arriving late in a working day’s schedule.