Safety and efficacy of 0.01% hypochlorous acid before cataract phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the efficacy of 0.01% hypochlorous acid as a conjunctival sac disinfectant before cataract phacoemulsification and its impact on the ocular surface.METHODS: Randomized controlled clinical trial. A total of 285 patients who were scheduled for cataract phacoemulsification surgery were randomly divided into the hypochlorous acid group and the povidone iodine group. Before and after disinfection, conjunctival sac swabs were taken, and bacterial culture and colony-forming units(CFUs)testing were performed using blood agar and chocolate agar media, respectively. All patients were evaluated for ocular symptom scores and pain severity scores 2 h, 1 d, and 1 wk after disinfection, and underwent corneal fluorescein staining, eye redness index, tear meniscus height, and noninvasive breakup time(NIBUT)examination. The incidence of endophthalmitis after surgery was recorded.RESULTS: Conjunctival sac disinfection with 0.01% hypochlorous acid significantly reduced the rate of positive bacterial cultures and colony-forming ability of the conjunctival sac, with statistically significant differences compared with the pre-disinfection period(both P<0.01), and the disinfecting ability of hypochlorous acid was comparable to that of povidone-iodine(χ2=0.811, P=0.368). The scores of ocular symptoms and pain severity in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(both P<0.01). The corneal fluorescein staining and eye redness index in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(all P<0.01). No endophthalmitis occurred in either group of patients. CONCLUSION: As a conjunctival sac disinfectant, 0.01% hypochlorous acid is safe and effective, with minimal discomfort and damage to the ocular surface in patients.

Antibacterial Effect of Hypochlorous Acid on Bacteria Associated with the Formation of Periodontal Biofilms: An in vitro Pilot Study

ABSTRACT Objective: To evaluate the antibacterial effect of electrolytically generated hypochlorous acid on Streptococcus gordonii, Fusobacterium nucleatum, and Porphyromonas gingivalis. Material and Methods: In this in vitro experiment, the effect of hypochlorous acid (HOCl) on the strains S. gordonii, F. nucleatum, and P. gingivalis was evaluated using 4% sodium hypochlorite, 0.12% chlorhexidine, and distilled water as controls. The four groups were placed on each plate, and each group was replicated five times. The agar diffusion method by zones measurement was used. The data were processed with SPSS using the Kruskal-Wallis test and multiple comparison tests. Results: Hypochlorous acid showed an average inhibition halo of 9.28 mm on S. gordonii. As expected with distilled water, no zone of inhibition was noted for any of the bacteria, nor were zones of inhibition observed with HOCl for F. nucleatum and P. gingivalis. Conclusion: Hypochlorous acid showed antimicrobial properties against only S. gordonii and was less effective than 4% sodium hypochlorite and 0.12% chlorhexidine, although no significant differences were found between the latter.

Comparación de la efectividad antimicrobiana entre hipoclorito de sodio 2, 5% y ácido hipocloroso 5% frente a Enterococcus faecalis: prueba in vitro / Comparison of antimicrobial effectiveness between sodium hypochlorite 2.5% and hypochlorous acid 5% against Enterococcus faecalis: an in vitro test

La terapia endodóntica tiene como uno de sus objetivos lograr la completa desinfección del sistema de conductos radiculares. Por esto, se deben seleccionar sustancias irrigantes que tengan la capacidad de eliminar todo el contenido de dicho sistema. La acción antimicrobiana es una de las características más importantes a tener en cuenta en la elección. El hipoclorito de sodio (NaOCl) tiene capacidad bactericida sobre muchos de los microorganismos de la flora endodóntica. El Enterococcus faecalis es una bacteria altamente resistente a antibacterianos que sobrevive en condiciones extremas. El ácido hipocloroso (HOCl) es una molécula derivada del NaOCl que ha demostrado tener alto poder bactericida sobre cepas patogénicas bucales. El objetivo de este trabajo fue evaluar y comparar la efectividad antimicrobiana in vitro del NaOCl 2.5% y el HOCl al 5% frente a Enterococcus faecalis. Una suspensión de Enterococcus faecalis (ATCC29212), de turbidez 0.5 en escala de McFarland, fue inoculada en varios tubos de ensayo, los cuales contenían cada antimicrobiano. Se dejaron actuar durante 1, 5 y 10 minutos para luego neutralizarlos e inclubarlos a 37º C en condiciones de capnofilia durante 48 hs. Todo el procedimiento se realizó por quintuplicado. Los resultados se midieron mediante recuento de UFC/ml. No se evidenció presencia de Enterococcus faecalis en las placas que contenían la solución de NaOCl al 2.5% como tampoco en aquellas que contenían HOCl al 5%. In vitro, el HOCl y el NaOCl en las concentraciones probadas, eliminaron completamente las cepas de Enterococcus faecalis (AU)

Short-term clinical effect of hypochlorous acid eye cleansing wipes on blepharitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the therapeutic effect on blepharitis by using hypochlorous acid eye cleansing wipes for 1wk. <p>METHODS: Prospective case-control study. Unlateral eyes of 48 patients with blepharitis who attended the ophthalmology clinic of our hospital on March 08, 2020 were selected and grouped according to the clinical diagnosis, including 16 patients in the staphylococcal blepharitis group and 22 patients in the seborrheic blepharitis group, 10 patients in the meibomian gland dysfunction blepharitis group. Hypochlorous acid eye cleansing wipes were given to clean the eyelid margin for 1wk, and related parameters of the eye surface and meibomian glands were collected before and after treatment.<p>RESULTS: Compared with pre-treatment, after 1wk of treatment, the overall ocular surface disease index(OSDI), conjunctival hyperemia, and eyelid margin hyperemia scores of the patients included in this study were significantly reduced(<i>P</i><0.001), and the OSDI scores of the three groups of patients were all significantly decreased, the tear film rupture time(TBUT)of patients in the seborrheic blepharitis group was significantly increased, and the degree of conjunctival congestion was significantly alleviated, and the scores of blepharocongestion in the staphylococcal blepharitis group and the seborrheic blepharitis group were both significantly decreased(<i>P</i><0.05).<p>CONCLUSION: The use of hypochlorous acid eye cleansing wipes to clean the eyelid margins for 1wk has a positive effect on different types of blepharitis. It could relieve the ocular symptoms of blepharitis and reduce the incidence of staphylococcal blepharitis and seborrheic blepharitis. Eyelid congestion, improve conjunctival hyperemia of seborrheic blepharitis, and improve tear film stability.

Clinical analysis of 0.01% hypochlorous acid eye drops in the treatment of bacterial corneal ulcer / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the role of 0.01% hypochlorous acid in the treatment of bacterial corneal ulcer. <p>METHODS: A total of 60 eyes of 60 patients with bacterial corneal ulcer who were admitted to the Department of Ophthalmology, the Affiliated Hospital of Xuzhou Medical University from August to December 2018 were randomly divided into control group and combined treatment group, 30 cases in each group. The control group was treated with antibiotic eye drops. The combined treatment group was treated with 0.01% hypochlorous acid aqueous solution on the basis of conventional treatment. The therapeutic effects of the two groups were observed and compared. <p>RESULTS: The ulcer healing time was significantly shortened in the combination group(<i>P</i>=0.005). However, there was no significant difference between the two groups in cure rate(<i>P</i>=0.643)and final visual acuity(<i>P</i>=0.787). There was a small number of patients with iridocyclitis in both groups, and the incidence was not statistically different(<i>P</i>=0.643). There were no complications such as corneal perforation and corneal neovascularization in both groups. Patients in the combination group had no obvious corneal irritation with 0.01% HOCI eye drops.<p>CONCLUSION: 0.01% hypochlorous acid eye drops can accelerate the healing rate of bacterial corneal ulcer without serious complications, indicating a promising future in the field of corneal ulcer treatment.

Establishment of optimal disinfection condition of weak acid hypochlorous solution for prevention of avian influenza and foot-and-mouth disease virus transmission / 대한수의학회지

This study examined the disinfection conditions (exposure time, 0–30 min; exposure temperature, 4℃–65℃) of hypochlorous acid water (HOCl) in automobile disinfection equipment. The study tested poliovirus type 1 (PV1), low pathogenic avian influenza virus (AIV, H9N2), and foot and mouth disease virus (FMDV, O type). As a result, the PV1 and FMD viruses were inactivated easily (virus titer 4 log value) by HOCl (> 100 ppm) but the AIV required higher exposure temperatures (> 55℃). In conclusion, the exposure temperature and time are important factors in deactivating AIV and FMDV.

Effect of smear layer deproteinization on bonding of self-etch adhesives to dentin: a systematic review and meta-analysis

OBJECTIVES: The aim of this systematic review was to critically analyze previously published studies of the effects of dentin surface pretreatment with deproteinizing agents on the bonding of self-etch (SE) adhesives to dentin. Additionally, a meta-analysis was conducted to quantify the effects of the above-mentioned surface pretreatment methods on the bonding of SE adhesives to dentin. MATERIALS AND METHODS: An electronic search was performed using the following databases: Scopus, PubMed and ScienceDirect. The online search was performed using the following keywords: ‘dentin’ or ‘hypochlorous acid’ or ‘sodium hypochlorite’ and ‘self-etch adhesive.’ The following categories were excluded during the assessment process: non-English articles, randomized clinical trials, case reports, animal studies, and review articles. The reviewed studies were subjected to meta-analysis to quantify the effect of the application time and concentration of sodium hypochlorite (NaOCl) and hypochlorous acid (HOCl) deproteinizing agents on bonding to dentin. RESULTS: Only 9 laboratory studies fit the inclusion criteria of this systematic review. The results of the meta-analysis revealed that the pooled average microtensile bond strength values to dentin pre-treated with deproteinizing agents (15.71 MPa) was significantly lower than those of the non-treated control group (20.94 MPa). CONCLUSIONS: In light of the currently available scientific evidence, dentin surface pretreatment with deproteinizing agents does not enhance the bonding of SE adhesives to dentin. The HOCl deproteinizing agent exhibited minimal adverse effects on bonding to dentin in comparison with NaOCl solutions.

Biocidal Effect of Hypochlorous Acid Solution, Neolox against Pathogenic Microorganisms

OBJECTIVE: Disinfection/sterilization of hospital devices prevents the occurrence of several infections; therefore, disinfectants are essential for public health. The purpose of this study was to evaluate the biocidal effect of a hypochlorous acid solution. METHODS: Hypochlorous acid solution, Neolox (Neo Chemical, Paju, Korea) obtained from Purester (Morinaga Engineering, Tokyo, Japan) was used. Antimicrobial activity of the solution against bacteria, yeasts, and mycobacteria at different exposure times (0.5, 1, 2, 5, 10, 15, and 30 minutes) was evaluated. RESULTS: All strains of bacteria and yeasts showed a 5-log10 reduction within 30 seconds of exposure to the solution, and mycobacteria showed the same reduction within 2 minutes. CONCLUSION: Hypochlorous acid solution has been widely used as a disinfectant in recent years. Neolox can be used as an effective intermediate- to high-level disinfectant for hospital infection control.

Ácido hipocloroso: una nueva alternativa como agente antimicrobiano y para la proliferación celular para uso en odontología / Hypochlorous acid: a new alternative as antimicrobial agent and for cell proliferation for use in dentistry

El ácido hipocloroso (HOCl) es un potente antimicrobiano no antibiótico utilizado en medicina clínica para el control de infecciones y reparación de heridas. In vivo el HOCl es sintetizado por células del sistema inmune para el control del agente patógeno durante la fagocitosis y ha sido sintetizado y estabilizado en el laboratorio con potenciales aplicaciones profilácticas y terapéuticas en medicina humana. El efecto antimicrobiano, antinflamatorio y en la proliferación celular lo hacen una sustancia que debe ser más evaluada para uso clínico en otras áreas de salud. Existe un interés en el desarrollo de nuevas sustancias antimicrobianas de uso tópico en odontología para el control del biofilm dental, la inflamación gingival y para la cicatrización de heridas de la mucosa oral. Se presenta una revisión de la literatura de los principales efectos del HOCl que sustentan su investigación y uso en odontología.

Hypochlorous acid (HOCl) is a powerful non antibiotic antimicrobial solution used in clinical medicine for infection control and wound healing. In vivo HOCl is produced by cells of the immune system to control the pathogen during phagocytosis and has been synthesized and stabilized in the laboratory with potential prophylactic and therapeutic applications in human medicine. The antimicrobial, anti-inflammatory and cell proliferation effect make it a substance to be evaluated in other health areas. There is interest to development of new antimicrobial substances for use in oral health for the control of dental biofilm, gingival inflammation and wound healing of the oral mucosa. A review of the literature of the main effects of HOCl that support its research and use in dentistry is presented.

Viability and Effects on Bacterial Proteins by Oral Rinses with Hypochlorous Acid as Active Ingredient

Abstract: This study investigated the effect of hypochlorous acid (HOCl) rinses and chlorhexidine (CHX) on the bacterial viability of S. mutans, A. israelii, P. gingivalis, A. actinomycetemcomitans, E. corrodens, C. rectus, K. oxytoca, K. pneumoniae and E. cloacae. The percentage of live bacteria was tested by fluorescence method using Live/Dead kit(r) and BacLight (Molecular Probes(r)) and compared between groups by the Kruskal-Wallis and U Mann-Whitney tests with Bonferroni correction (p value<0.012). The effect of HOCl and CHX on total proteins of P. gingivalis and S. mutans was determined by SDS-PAGE. CHX showed a higher efficacy than HOCl against S. mutans, A. israelii, E. corrodens and E. cloacae (p<0.001) while HOCl was more effective than CHX against P. gingivalis, A. actinomycetemcomitans, C. rectus and K. oxytoca (p=0.001). CHX and HOCl had similar efficacy against K. pneumoniae. Proteins of P. gingivalis and S. mutans were affected similarly by HOCl and CHX. HOCl reduced the bacterial viability especially in periodontopathic bacteria, which may support its use in the control of subgingival biofilm in periodontal patients.

Resumo: Este estudo investigou o efeito de enxaguantes à base de ácido hipocloroso (HOCl) e clorexidina (CHX) sobre a viabilidade bacteriana de S. mutans, A. israelii, P. gingivalis, A. actinomycetemcomitans, E. corrodens, C. rectus, K. oxytoca, K. pneumoniae e E. cloacae. O percentual de bactérias sobreviventes foi testado pelo método de fluorescência utilizando Live/Dead kit(r) e BacLight (Molecular Probes(r)), fazendo comparação entre os grupos com os testes de Kruskal-Wallis e U Mann-Whitney e correção de Bonferroni (p<0,012). O efeito de HOCl e CHX sobre P. gingivalis e S. mutans foi determinado por SDS-PAGE. O CHX mostrou eficácia superior ao HOCl contra S. mutans, A. israelii, E. corrodens e E. cloacae (p<0,001), ao passo que P. gingivalis, A. actinomycetemcomitans, C. rectus e K. oxytoca foram melhores que o CHX para o HOCl (p=0,001). O K. pneumoniae teve efeito similar para o CHX e para o HOCl. As proteínas de P. gingivalis e S. mutans foram afetadas de modo semelhante por CHX e HOCl. O HOCl reduziu a viabilidade bacterial, especialmente nas bactérias periodontopáticas, o que pode recomendar o uso no controle do biofilme subgingival em pacientes periodentais.

Effect of Super-Oxidized Water, Sodium Hypochlorite and EDTA on Dentin Microhardness

The present study aimed to evaluate the influence of the following irrigating solutions on the microhardness of root canal dentin: 2% sodium hypochlorite (2NaOCl), 5% sodium hypochlorite (5NaOCl), super-oxidized water (400 ppm Sterilox - Sx) and 17% EDTA (E). Eighty roots from bovine incisors were randomly divided into 8 groups (n=10): 2NaOCl, 5NaOCl, Sx, and 2NaOCl + E, 5NaOCl + E, Sx + E (associated with E as final irrigant for 5 min), E solely and distilled water (dH2O) as the negative control. Root canal preparation was performed by hand instruments, using one of the irrigation protocols for 30 min. Then, 5 mm of the cervical root third were cut out from each sample and subjected to the Vickers microhardness test, at two points, one at approximately 500-1000 µm from the root canal lumen (distance 1), and the other at approximately 500-1000 µm from the external root surface (distance 2). Data were analyzed by Wilcoxon and Kruskal-Wallis tests at 5% significance level. Microhardness values at distance 1 were significantly lower than those at distance 2 for all groups, except 5NaOCl and 5NaOCl + E groups (p>0.05). EDTA showed the lowest microhardness values. However, no statistically significant difference was detected among groups at distance 1 and EDTA was significantly different only from Sx at distance 2. In conclusion, all tested solutions showed lower microhardness at the most superficial root canal dentin layer compared to the one found near the external root surface, except 5NaOCl and 5NaOCl + E; EDTA promoted lower microhardness values in comparison to Sterilox at this site.

O presente estudo teve como objetivo avaliar a influência das seguintes soluções irrigadoras na microdureza da dentina do canal radicular: hipoclorito de sódio a 2% (NaOCl2), hipoclorito de sódio a 5% (NaOCl5), água superoxidada (Sterilox(r) 400 ppm - Sx) e EDTA a 17% (E). Oitenta raízes de incisivos bovinos foram divididas aleatoriamente em 8 grupos (n=10): NaOCl2, NaOCl5, Sx e NaOCl2 + E, NaOCl5 + E, Sx + E (associados ao E como irrigante final por 5 min), E isolado e água destilada (H2Od), como controle negativo. O preparo dos canais radiculares foi realizado com instrumentos manuais, usando um dos protocolos de irrigação por 30 min. A seguir, 5 mm do terço cervical de cada amostra foram cortados perpendicularmente e submetidos ao teste de microdureza de Vickers, em dois pontos, um aproximadamente 500-1000 µm da luz do canal radicular (distância 1), e o outro aproximadamente 500-1000 µm da superfície externa da raiz (distância 2). Os dados foram analisados pelos testes de Wilcoxon e Kruskal-Wallis com um nível de significância de 5%. Os valores de microdureza na distância 1 foram significativamente menores do que na distância 2 para todos os grupos, exceto NaOCl5 e NaOCl5 +E (p>0,05). O EDTA mostrou os menores valores de microdureza. No entanto, não foi detectada diferença estatisticamente significativa entre os grupos na distância 1 e o EDTA foi significativamente diferente apenas do Sx na distância 2. Pode-se concluir que todas as soluções testadas mostraram menor microdureza na camada de dentina mais superficial do canal radicular em comparação aos valores encontrados próximo à superfície radicular externa, exceto NaOCl5 e NaOCl5 + E; o EDTA promoveu menor microdureza em comparação ao Sterilox(r) neste ponto.

The use of Hypochlorous Acid as a Model for Investigating Bladder Overactivity

Involuntary detrusor contractions play an important role in the development of urge incontinence. Also in an in-vitro situation contractions which develop spontaneously can be seen; a parallel with the in vivo observations is likely. In order to study this muscle overactivity we investigated the possibility to induce this phenomenon with oxidative stress using hypochlorous acid (HOCl). Materials and Methods Urinary bladder muscle strips from pigs were mounted in a custom made organ bath and incubated for 20 minutes in Krebs solution. Next HOCl (10µM) was added to the organ bath and the onset of overactive contractions was closely followed. Overactivity was defined as a development of more than 5 phasic detrusor contractions per minute without any other provocation in the 30 minutes following addition of HOCl to the organ bath. Results Of the 50 strips which were used 36 (72%) became overactive after exposure to HOCl during 30 minutes recording. In 76% of the overactive strips overactivity occurred within 5 minutes, in 19% between 5 and 15 minutes, and in 5% it took longer than 15 minutes. The overactivity could be stopped by washing out HOCl for 10 minutes after which still a significant contraction after EFS and ACh stimulation was seen. Conclusions It can be concluded that an oxidative stressor, like HOCl, is capable of inducing smooth muscle overactivity. This model can be used for the development and testing of new treatment modalities for the overactive detrusor. Furthermore, this study provides evidence for a causal relationship between oxidative stress and detrusor overactivity. .

Oxidation of Bovine Albumin by Hypochlorous and Hypobromous Acids: Structural and Functional Alterations.

Aims: Hypochlorous (HOCl) and hypobromous (HOBr) acids are among the most powerful oxidants produced by the innate immune cells. Albumin is the predominant protein in most body fluids and is considered the most important antioxidant of blood plasma. Study Design: Oxidation of bovine albumin (BSA) and study of its structural and functional alterations. Place and Duration of Study: Faculty of Science and Faculty of Pharmaceutical Science, University of the State of Sao Paulo UNESP, between June and December 2012. Methodology: BSA was oxidized with excess of HOCl or HOBr and its structural and functional alterations were analyzed by spectroscopic techniques as UV-Vis absorption, intrinsic and synchronous fluorescence, fluorescence quenching, Rayleigh scattering and circular dichroism. Results: Both oxidants were able to deplete the intrinsic fluorescence of BSA, but HOBr was more effective than HOCl. The alterations in the synchronous fluorescence, UV-Vis absorption, and the appearance of a fluorescence band centered at 450 nm confirmed the difference between the oxidants. The oxidation did not induce aggregation of BSA as measured by Rayleigh scattering. The far-UV circular dichroism spectra showed a loss in the helical content and the near-UV-circular dichroism showed an alteration in the tertiary structure; HOBr was the more effective of the oxidants in this case. However, the oxidations did not induce significant alterations in the binding capacity of BSA, which was evaluated using hydrophobic (norfloxacin) and hydrophilic (ascorbic acid) drugs. Conclusion: These results suggest that, although highly susceptible to oxidation, the alterations did not inhibit BSA’s physiological function as a transport protein.

Efecto micobactericida del ácido hipocloroso en tres especies ambientales potencialmente patógenas y en Mycobacterium tuberculosis / Mycobactericidal effect of hypochlorous acid in three potentially pathogenic environmental species and in Mycobacterium tuberculosis

Objetivo. Evaluar el efecto micobactericida del ácido hipocloroso siguiendo las normas internacionales de desarrollo de nuevos desinfectantes. Materiales y métodos. Se evaluó la efectividad del ácido hipocloroso en Mycobacterium chelonae, M. fortuitum, M. intracellulare y M. tuberculosis en diferentes concentraciones en cuatro intervalos de tiempo, a 225 ppm, 450 ppm, 750 ppm y 1.500 ppm, durante 5, 10, 15 y 20 minutos. Las pruebas desarrolladas fueron: exposición directa al desinfectante en condiciones limpias, exposición con interferencia (condiciones sucias), exposición en superficies en condiciones limpias y prueba de corrosión del desinfectante. Resultados. Todas las concentraciones evaluadas del ácido hipocloroso en condiciones limpias, es decir, en exposición directa y en superficies, resultaron ser efectivas durante todos los intervalos de tiempo, mientras que para la prueba con interferencia, fue necesario aumentar el tiempo, la concentración o ambos para tener, al menos, un 99,9 % de efectividad del desinfectante sobre la concentración bacteriana usada; estos resultados probablemente dependieron de la reducción de la concentración del ácido hipocloroso, causada por la interferencia con albúmina y de la resistencia intrínseca de cada especie micobacteriana. Conclusiones. El ácido hipocloroso es 100 % efectivo en todos los intervalos de tiempo y a todas las concentraciones evaluadas en condiciones limpias, y demostró ser efectivo después de lavados que arrastren con la mayoría de materia orgánica en una superficie, debido a que, en condiciones sucias, sólo es efectivo con las concentraciones más altas (900 y 1.500 ppm) y en tiempos mayores de 15 minutos.

Objective: to evaluate the mycobactericidal effect of hypochlorous acid according to the international standards for the development of new disinfectants. Materials and methods: the effectiveness of hypochlorous acid in M. chelonae, M. fortuitum, M. intracellulare and M. tuberculosis was evaluated at different disinfectant concentrations in 4 time intervals, at 225 ppm, 450 ppm, 750 ppm and 1500 ppm for 5, 10, 15 and 20 minutes. The main tests Results: all concentrations of hypochlorous acid tested in clean conditions, i.e. in direct exposure and in surfaces, were found to be effective at all the time intervals, while for the test with interference it was necessary to increase the time and/or concentration of the disinfectant for it to be at least 99.9% effective in the bacterial concentration used; these results were likely due to the reduction of acid concentration caused by the albumin used as interference and the intrinsic resistance of each mycobacterial species. Conclusions: hypochlorous acid is 100% effective in clean conditions at all the time intervals and in all the concentrations tested, proving to be effective after performing washes that drag away most organic matter on a surface, as in contaminated conditions its effectiveness is reduced to just higher disinfectant concentrations (900 and 1500 ppm) and times longer than 15 minutes.

The Symptom Improvement of Adjunctive Hypochlorous Acid Nasal Cavity Irrigation in Post-Surgically Intractable Chronic Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Low concentration hypochlorous acid is known for being an endogenous anti-bacterial and anti-viral agent. Saline irrigation has been used as an adjunctive treatment for patients with chronic sinusitis. In this study, we tried to compare the effectiveness of hypochlorous acid and saline nasal irrigation to patients with intractable sinusitis after surgery. SUBJECTS AND METHOD: A total of 35 patients who had a frequent relapse of chronic sinusitis or had persisting symptoms post-surgically were recruited. The experimental group was given hypochlorous acid and saline nasal irrigation, while the control group was given saline nasal irrigation for eight weeks. The curative effects were assessed on the basis of the symptom score, nasal endoscopic score, bacterial culture, and inflammatory cytokines on the first day, fourth week, and eighth week after treatment. RESULTS: A total of 26 participants were assessed. The study finally consisted of 15 patients in experimental group and 11 in the control group. The symptom scores in the experimental group were substantially lower before, and after four and eight weeks of treatment. However, there was no specific difference in symptom score improvement between the two groups. The endoscopic score improved in experimental group (p<0.01). Similar tendencies were shown in the bacterial culture test of both groups. In the experimental group, the values of TNF-alpha, IL-8, and IL-1beta decreased in the fourth week, whereas they increased in the eighth week. CONCLUSION: Hypochlorous acid nasal irrigation may be to used as an alternative adjunctive treatment in addition to saline irrigation.

The Safety of Low Concentration Hypochlorous Acid as an Oral Gargle Solution and Its Anti-Microbial Effects / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The authors aimed to evaluate the safety of low concentration hypochlorous acid as an oral gargle solution. To do this, we carried out in vitro and in vivo experiments and evaluated its efficacy by compared with normal saline and chlorhexidine gargle using throat culture before and after gargling. MATERIALS AND METHOD: The authors treated oral mucosal epithelial cell with 3.5 ppm hypochlorous acid and evaluated cytotoxicity. For evaluation of morphological change, oral mucosa specimens were obtained during surgery before 30 minutes and 2 hours after treatment with hypochlorous acid. The specimens were evaluated with light microscopy. For evaluation of efficacy, we performed oral gargle with normal saline, chlorhexidine and hypochlorous acid in 10 healthy volunteers. The throat cultures were performed before and after each gargling. Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Klebsiella pneumoniae, Aspergillus fumigatus, Rhizopus oryzae were evaluated semi-quantitatively (Grade 0 to 4). RESULTS: There was no cellular toxicity in MTT assay and the morphological changes were not observed. Both chlorhexidine and hypochlorous acid showed significant decrease of microbes (chlorhexidine: p=0.036, hypochlorous acid: p=0.031). There was no significant differences between them (p=0.217). CONCLUSION: Low concentration hypochlorous acid is safe for the oral mucosal epithelium and has antimicrobial efficacy similar to that of chlorhexidine.

Effect of aquatine endodontic cleanser on smear layer removal in the root canals of ex vivo human teeth

OBJECTIVES: The purpose of this study was to measure and compare the root canal cleanliness and smear layer removal effectiveness of Aquatine Endodontic Cleanser (Aquatine EC) when used as an endodontic irrigating solution in comparison with 6 percent sodium hypochlorite (NaOCl). MATERIAL AND METHODS: Forty-five human teeth were randomly allocated to five treatment groups; the pulp chamber was accessed, cleaned, and shaped by using ProTaper and ProFile rotary instrumentation to an ISO size #40. The teeth were then processed for scanning electron microscopy, and the root canal cleanliness and removal of smear layer were examined. RESULTS: The most effective removal of smear layer occurred with Aquatine EC and NaOCl, both with a rinse of EDTA. CONCLUSIONS: Aquatine EC appears to be the first hypochlorous acid approved by the FDA to be a possible alternative to the use of NaOCl as an intracanal irrigant. Further research is needed to identify safer and more effective alternatives to the use of NaOCl irrigation in endodontics.

Inhibition of peroxidase activity and scavenging of reactive oxygen species by astilbin isolated from Dimorphandra mollis (Fabaceae, Caesalpinioideae)

Astilbin (5,7,3’,4’-tetrahydroxy-2,3-dihydroflavonol-3-ß-o-rhamnoside), a flavonoid with a large range of biological activities, was isolated from Dimorphandra mollis, a shrub common to the Brazilian Cerrado. The purpose of this study is to verify the effects of astilbin on myeloperoxidase (MPO) and horseradish peroxidase (HRP), and its antioxidant activity against hypochlorous acid (HOCl) and total antioxidant activity (TAC) by the 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) radical cation (ABTS•+). Astilbin inhibited MPO and HRP activities in a concentration-dependent relationship and effectively scavenged HOCl. The TAC by ABTS•+ of astilbin (IC50 ~ 20 mM) was higher than that of uric acid, which was used as a positive control. These data demonstrate that astilbin is a potent antioxidant and that it inhibits MPO and HRP activities efficiently.

Role of NADPH oxidase in the regulation of vascular endothelial cell inflammation induced by hypochlorite-modified albumin / 中华肾脏病杂志

Objective To elucidate the mechanism of inflammation in vascular endothelial cells induced by hypochlorite-modified albumin (HOCl-Alb). Methods HOCl-Alb-induced NADPH oxidase activity in human umbilical vein endothelial cells (HUVEC) was measured by lucigenin-enhanced chemiluminescence. Phosphorylation of p47phox and binding of p47phox and p22phox were measured with immunoprecipitation and Western blotting. Membrane translocation of p47phox was measured with immunofluorescence. RT-PCR and Western blotting were used to determine the intercellular adhesion molecule-1 (ICAM-1) mRNA and protein expression in the presence or absence of apocynin, respectively. Results Co-incubation of HUVEC with HOClAlb resulted in the enhancement of NAIDPH oxidase activity in time- and dose-dependent manner.Compared with bovine serum albumin group, exposure of the cells with 200 mg/L HOCl-Alb for 15min resulted in a 6.16-fold increase in NADPH oxidase activity. Phosphorylation and membrane translocation of p47phox and binding of it with p22phox were also induced by HOCl-Alb. ICAM-1expression was up-regulated after exposure to HOCl-Alb and this effect was significantly abolished by apocynin, a specific inhibiter of NADPH oxidase, in dose-dependent manner. Preincubation of the cells with 500 μmol/L apocynin inhibited the expression of ICAM-1 protein induced by HOClAlb by 68.97% (P＜0.01). Conclusion NADPH oxidase plays a central role in HOCl-Albmediated ICAM-1 expression and provides a mechanism for HOCl-Alb-related vascular endothelial inflammation.