Effectiveness of FDA-cleared Wound Cleansers for Disinfection of Surgical Surfaces in Resource Limited Environments.

BACKGROUND: Service members experience unique circumstances when providing medical care in austere environments. Some challenges include supply shortages and the need to perform surgery in extreme temperatures. As such, methods for the sanitization of medical tools are sought and efficacy of existing materiel sourced to austere medical facilities should be examined for this purpose. This study tested the efficacy of commercially available, FDA-approved wound cleansers for alternative use as a potential sanitizer of stainless-steel medical devices and instruments found at improvised medical facilities. METHODS: Escherichia coli and Staphylococcus aureus cultures were inoculated onto sterile stainless-steel carriers. After cleanser treatment, samples were held for 2 h, 24 h, or 7 days to represent different turn-around times between uses at ambient (25 °C), cold (-20 °C) and hot (50 °C) temperatures. Additional ex vivo challenges were performed using slurry harvested from porcine cecum. Colony-forming units and log reduction were calculated. Significance was determined using one-way ANOVA and multiple comparisons between treatment groups were calculated using Tukey's multiple comparison test. RESULTS: All wound cleansers demonstrated statistically significant bactericidal activity against lab bacteria and ex vivo cecal slurry. E. coli and S. aureus resulted in approximately a 5-6 log reduction on average, resulting in no growth after treatment for all cleaners at 2 and 24 h. Similarly, 7-day post exposure results in a 6-log reduction after treatment for all groups at 25 °C and -25 °C. While treatment of ex vivo samples did not result in total kill, significant reductions in bacterial load were observed in all groups. CONCLUSIONS: Wound cleansers cleared for use in surgical settings demonstrated antimicrobial effects against bacteria deposited on metal surfaces. These cleansers decreased bacterial viability when challenged against extreme temperatures and few bacteria were harvested from treated surfaces even after 7 days. FDA-approved wound cleaners show promise as a potential sanitizer in resource limited environments.

Mitigation of SARS-CoV-2 by Using Transition Metal Nanozeolites and Quaternary Ammonium Compounds as Antiviral Agents in Suspensions and Soft Fabric Materials.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has demonstrated the need for novel, affordable, and efficient reagents to help reduce viral transmission, especially in high-risk environments including medical treatment facilities, close quarters, and austere settings. We examined transition-metal nanozeolite suspensions and quaternary ammonium compounds as an antiviral surface coating for various textile materials. Methods: Zeolites are crystalline porous aluminosilicate materials, with the ability of ion-exchanging different cations. Nanozeolites (30 nm) were synthesized and then ion-exchanged with silver, zinc and copper ions. Benzalkonium nitrate (BZN) was examined as the quaternary ammonium ion (quat). Suspensions of these materials were tested for antiviral activity towards SARS-CoV-2 using plaque assay and immunostaining. Suspensions of the nanozeolite and quat were deposited on polyester and cotton fabrics and the ability of these textiles towards neutralizing SARS-CoV-2 was examined. Results: We hypothesized that transition metal ion containing zeolites, particularly silver and zinc (AM30) and silver and copper (AV30), would be effective in reducing the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Additionally, AM30 and AV30 antiviral potency was tested when combined with a quaternary ammonium carrier, BZN. Our results indicate that exposure of SARS-CoV-2 to AM30 and/or AV30 suspensions reduced viral loads with time and exhibited dose-dependence. Antiviral activities of the combination of zeolite and BZN compositions were significantly enhanced. When used in textiles, AM30 and AV30-coated cotton and polyester fabrics alone or in combination with BZN exhibited significant antiviral properties, which were maintained even after various stress tests, including washes, SARS-CoV-2-repeated exposures, or treatments with soil-like materials. Conclusion: This study shows the efficacy of transition metal nanozeolite formulations as novel antiviral agents and establishes that nanozeolite with silver and zinc ions (AM30) and nanozeolite with silver and copper ions (AV30) when combined with benzalkonium nitrate (BZN) quickly and continuously inactivate SARS-CoV-2 in suspension and on fabric materials.

The hurdles of nanotoxicity in transplant nanomedicine.

Nanomedicine has matured significantly in the past 20 years and a number of nanoformulated therapies are cleared by regulatory agencies for use across the globe. Transplant medicine is one area that has significantly benefited from the advancement of nanomedicine in recent times. However, while nanoparticle-based therapies have improved toxicological profiles of some drugs, there are still a number of aspects regarding the biocompatibility and toxicity of nanotherapies that require further research. The goal of this article is to review toxicological profiles of immunosuppressant therapies and their conversion into nanomedicine formulations as well as introduce future challenges associated with current in vitro and in vivo toxicological models.

Quantifying engineered nanomaterial toxicity: comparison of common cytotoxicity and gene expression measurements.

BACKGROUND: When evaluating the toxicity of engineered nanomaterials (ENMS) it is important to use multiple bioassays based on different mechanisms of action. In this regard we evaluated the use of gene expression and common cytotoxicity measurements using as test materials, two selected nanoparticles with known differences in toxicity, 5 nm mercaptoundecanoic acid (MUA)-capped InP and CdSe quantum dots (QDs). We tested the effects of these QDs at concentrations ranging from 0.5 to 160 µg/mL on cultured normal human bronchial epithelial (NHBE) cells using four common cytotoxicity assays: the dichlorofluorescein assay for reactive oxygen species (ROS), the lactate dehydrogenase assay for membrane viability (LDH), the mitochondrial dehydrogenase assay for mitochondrial function, and the Comet assay for DNA strand breaks. RESULTS: The cytotoxicity assays showed similar trends when exposed to nanoparticles for 24 h at 80 µg/mL with a threefold increase in ROS with exposure to CdSe QDs compared to an insignificant change in ROS levels after exposure to InP QDs, a twofold increase in the LDH necrosis assay in NHBE cells with exposure to CdSe QDs compared to a 50% decrease for InP QDs, a 60% decrease in the mitochondrial function assay upon exposure to CdSe QDs compared to a minimal increase in the case of InP and significant DNA strand breaks after exposure to CdSe QDs compared to no significant DNA strand breaks with InP. High-throughput quantitative real-time polymerase chain reaction (qRT-PCR) data for cells exposed for 6 h at a concentration of 80 µg/mL were consistent with the cytotoxicity assays showing major differences in DNA damage, DNA repair and mitochondrial function gene regulatory responses to the CdSe and InP QDs. The BRCA2, CYP1A1, CYP1B1, CDK1, SFN and VEGFA genes were observed to be upregulated specifically from increased CdSe exposure and suggests their possible utility as biomarkers for toxicity. CONCLUSIONS: This study can serve as a model for comparing traditional cytotoxicity assays and gene expression measurements and to determine candidate biomarkers for assessing the biocompatibility of ENMs.

Deriving a provisional tolerable intake for intravenous exposure to silver nanoparticles released from medical devices.

Silver nanoparticles (AgNP) are incorporated into medical devices for their anti-microbial characteristics. The potential exposure and toxicity of AgNPs is unknown due to varying physicochemical particle properties and lack of toxicological data. The aim of this safety assessment is to derive a provisional tolerable intake (pTI) value for AgNPs released from blood-contacting medical devices. A literature review of in vivo studies investigating critical health effects induced from intravenous (i. v.) exposure to AgNPs was evaluated by the Annapolis Accords principles and Toxicological Data Reliability Assessment Tool (ToxRTool). The point of departure (POD) was based on an i. v. 28-day repeated AgNP (20 nm) dose toxicity study reporting an increase in relative spleen weight in rats with a 5% lower confidence bound of the benchmark dose (BMDL05) of 0.14 mg/kg bw/day. The POD was extrapolated to humans by a modifying factor of 1,000 to account for intraspecies variability, interspecies differences and lack of long-term toxicity data. The pTI for long-term i. v. exposure to 20 nm AgNPs released from blood-contacting medical devices was 0.14 µg/kg bw/day. This pTI may not be appropriate for nanoparticles of other physicochemical properties or routes of administration. The methodology is appropriate for deriving pTIs for nanoparticles in general.

Silver nanoparticles: Significance of physicochemical properties and assay interference on the interpretation of in vitro cytotoxicity studies.

Silver nanoparticles (AgNPs) have generated a great deal of interest in the research, consumer product, and medical product communities due to their antimicrobial and anti-biofouling properties. However, in addition to their antimicrobial action, concerns have been expressed about the potential adverse human health effects of AgNPs. In vitro cytotoxicity studies often are used to characterize the biological response to AgNPs and the results of these studies may be used to identify hazards associated with exposure to AgNPs. Various factors, such as nanomaterial size (diameter), surface area, surface charge, redox potential, surface functionalization, and composition play a role in the development of toxicity in in vitro test systems. In addition, the interference of AgNPs with in vitro cytotoxicity assays may result in false negative or false positive results in some in vitro biological tests. The goal of this review is to: 1) summarize the impact of physical-chemical parameters, including size, shape, surface chemistry and aggregate formation on the in vitro cytotoxic effects of AgNPs; and 2) explore the nature of AgNPs interference in in vitro cytotoxicity assays.

Biocompatibility and antibacterial activity of nitrogen-doped titanium dioxide nanoparticles for use in dental resin formulations.

The addition of antibacterial functionality to dental resins presents an opportunity to extend their useful lifetime by reducing secondary caries caused by bacterial recolonization. In this study, the potential efficacy of nitrogen-doped titanium dioxide nanoparticles for this purpose was determined. Nitrogen doping was carried out to extend the ultraviolet absorbance into longer wavelength blue light for increased biocompatibility. Titanium dioxide nanoparticles (approximately 20-30 nm) were synthesized with and without nitrogen doping using a sol-gel method. Ultraviolet-Visible spectroscopy indicated a band of trap states, with increasing blue light absorbance as the concentration of the nitrogen dopant increased. Electron paramagnetic resonance measurements indicated the formation of superoxide and hydroxyl radicals upon particle exposure to visible light and oxygen. The particles were significantly toxic to Escherichia coli in a dose-dependent manner after a 1-hour exposure to a blue light source (480 nm). Intracellular reactive oxygen species assay demonstrated that the particles caused a stress response in human gingival epithelial cells when exposed to 1 hour of blue light, though this did not result in detectable release of cytokines. No decrease in cell viability was observed by water-soluble tetrazolium dye assay. The results show that nitrogen-doped titanium dioxide nanoparticles have antibacterial activity when exposed to blue light, and are biocompatible at these concentrations.

Intracellular accumulation and dissolution of silver nanoparticles in L-929 fibroblast cells using live cell time-lapse microscopy.

Cytotoxicity assessments of nanomaterials, such as silver nanoparticles, are challenging due to interferences with test reagents and indicators as well uncertainties in dosing as a result of the complex nature of nanoparticle intracellular accumulation. Furthermore, current theories suggest that silver nanoparticle cytotoxicity is a result of silver nanoparticle dissolution and subsequent ion release. This study introduces a novel technique, nanoparticle associated cytotoxicity microscopy analysis (NACMA), which combines fluorescence microscopy detection using ethidium homodimer-1, a cell permeability marker that binds to DNA after a cell membrane is compromised (a classical dead-cell indicator dye), with live cell time-lapse microscopy and image analysis to simultaneously investigate silver nanoparticle accumulation and cytotoxicity in L-929 fibroblast cells. Results of this method are consistent with traditional methods of assessing cytotoxicity and nanoparticle accumulation. Studies conducted on 10, 50, 100 and 200 nm silver nanoparticles reveal size dependent cytotoxicity with particularly high cytotoxicity from 10 nm particles. In addition, NACMA results, when combined with transmission electron microscopy imaging, reveal direct evidence of intracellular silver ion dissolution and possible nanoparticle reformation within cells for all silver nanoparticle sizes.

Ionic liquids as a class of materials for transdermal delivery and pathogen neutralization.

Biofilm-protected microbial infections in skin are a serious health risk that remains to be adequately addressed. The lack of progress in developing effective treatment strategies is largely due to the transport barriers posed by the stratum corneum of the skin and the biofilm. In this work, we report on the use of Ionic Liquids (ILs) for biofilm disruption and enhanced antibiotic delivery across skin layers. We outline the syntheses of ILs, analysis of relevant physicochemical properties, and subsequent neutralization effects on two biofilm-forming pathogens: Pseudomonas aeruginosa and Salmonella enterica. Further, the ILs were also examined for cytotoxicity, skin irritation, delivery of antibiotics through the skin, and treatment of biofilms in a wound model. Of the materials examined, choline-geranate emerged as a multipurpose IL with excellent antimicrobial activity, minimal toxicity to epithelial cells as well as skin, and effective permeation enhancement for drug delivery. Specifically, choline-geranate was comparable with, or more effective than, bleach treatment against established biofilms of S. enterica and P. aeruginosa, respectively. In addition, choline-geranate increased delivery of cefadroxil, an antibiotic, by >16-fold into the deep tissue layers of the skin without inducing skin irritation. The in vivo efficacy of choline-geranate was validated using a biofilm-infected wound model (>95% bacterial death after 2-h treatment). This work establishes the use of ILs for simultaneous enhancement of topical drug delivery and antibiotic activity.

Functionalization-dependent induction of cellular survival pathways by CdSe quantum dots in primary normal human bronchial epithelial cells.

Quantum dots (QDs) are semiconductor nanocrystals exhibiting unique optical properties that can be exploited for many practical applications ranging from photovoltaics to biomedical imaging and drug delivery. A significant number of studies have alluded to the cytotoxic potential of these materials, implicating Cd-leaching as the causal factor. Here, we investigated the role of heavy metals in biological responses and the potential of CdSe-induced genotoxicity. Our results indicate that, while negatively charged QDs are relatively noncytotoxic compared to positively charged QDs, the same does not hold true for their genotoxic potential. Keeping QD core composition and size constant, 3 nm CdSe QD cores were functionalized with mercaptopropionic acid (MPA) or cysteamine (CYST), resulting in negatively or positively charged surfaces, respectively. CYST-QDs were found to induce significant cytotoxicity accompanied by DNA strand breakage. However, MPA-QDs, even in the absence of cytotoxicity and reactive oxygen species formation, also induced a high number of DNA strand breaks. QD-induced DNA damage was confirmed by identifying the presence of p53 binding protein 1 (53BP1) in the nuclei of exposed cells and subsequent diminishment of p53 from cytoplasmic cellular extracts. Further, high-throughput real-time PCR analyses revealed upregulation of DNA damage and response genes and several proinflammatory cytokine genes. Most importantly, transcriptome sequencing revealed upregulation of the metallothionein family of genes in cells exposed to MPA-QDs but not CYST-QDs. These data indicate that cytotoxic assays must be supplemented with genotoxic analyses to better understand cellular responses and the full impact of nanoparticle exposure when making recommendations with regard to risk assessment.

Comprehensive analysis of the effects of CdSe quantum dot size, surface charge, and functionalization on primary human lung cells.

The growing potential of quantum dots (QDs) in applications as diverse as biomedicine and energy has provoked much dialogue about their conceivable impact on human health and the environment at large. Consequently, there has been an urgent need to understand their interaction with biological systems. Parameters such as size, composition, surface charge, and functionalization can be modified in ways to either enhance biocompatibility or reduce their deleterious effects. In the current study, we simultaneously compared the impact of size, charge, and functionalization alone or in combination on biological responses using primary normal human bronchial epithelial cells. Using a suite of cellular end points and gene expression analysis, we determined the biological impact of each of these properties. Our results suggest that positively charged QDs are significantly more cytotoxic compared to negative QDs. Furthermore, while QDs functionalized with long ligands were found to be more cytotoxic than those functionalized with short ligands, negative QDs functionalized with long ligands also demonstrated size-dependent cytotoxicity. We conclude that QD-elicited cytotoxicity is not a function of a single property but a combination of factors. The mechanism of toxicity was found to be independent of reactive oxygen species formation, as cellular viability could not be rescued in the presence of the antioxidant n-acetyl cysteine. Further exploring these responses at the molecular level, we found that the relatively benign negative QDs increased gene expression of proinflammatory cytokines and those associated with DNA damage, while the highly toxic positive QDs induced changes in genes associated with mitochondrial function. In an attempt to tentatively "rank" the contribution of each property in the observed QD-induced responses, we concluded that QD charge and ligand length, and to a lesser extent, size, are key factors that should be considered when engineering nanomaterials with minimal bioimpact (charge > functionalization > size).

Physicochemical and toxicological properties of commercial carbon blacks modified by reaction with ozone.

Ozonation of two commercial carbon blacks (CBs), Printex 90 (P90) and Flammruss 101 (F101), was carried out and changes in their morphology, physical properties, and cytotoxicity were examined. The hypothesis examined was that different methods of manufacture of CBs influence their chemical reactivity and toxicological properties. Structural changes were examined by X-ray photoelectron spectroscopy, infrared spectroscopy, Raman spectroscopy, and electron paramagnetic resonance spectroscopy (EPR). Introduction of surface oxygen functionality upon ozonation led to changes in surface charge, aggregation characteristics, and free radical content of the CBs. However, these changes in surface functionality did not alter the cytotoxicity and release of inflammation markers upon exposure of the CBs to murine macrophages. Interaction of macrophages with F101 resulted in higher levels of inflammatory markers than P90, and the only structural correlation was with the higher persistent radical concentration on the F101.

Contrast of the biological activity of negatively and positively charged microwave synthesized CdSe/ZnS quantum dots.

Quantum dots (QDs) are semiconductor nanocrystals that have found use in bioimaging, cell tracking, and drug delivery. This article compares the cytotoxicity and cellular interactions of positively and negatively charged CdSe/CdS/ZnS QDs prepared by a microwave method using a murine alveolar macrophage-like cell culture model. Keeping the core semiconductor the same, QD charge was varied by altering the surface capping molecule; negatively charged QDs were formed with mercaptopropionic acid (MPA-QDs) and positively charged QDs with thiocholine (THIO-QDs). The size and charge of these two QDs were investigated in three types of media (RPMI, RPMI + FBS, and X-VIVO serum-free media) relevant for the biological studies. MPA-QDs were found to have negative zeta potential in RPMI, RPMI + FBS, and serum-free media and had sizes ranging from 8 to 54 nm. THIO-QDs suspended in RPMI alone were <62 nm in size, while large aggregates (greater than 1000 nm) formed when these QDs were suspended in RPMI + FBS and serum-free media. THIO-QDs retained positive zeta potential in RPMI and were found to have a negative zeta potential in RPMI + FBS and nearly neutral zeta potential in serum-free media. In a cell culture model, both MPA-QDs and THIO-QDs caused comparable levels of apoptosis and necrosis. Both QDs induced significant tumor necrosis factor-alpha (TNF-α) secretion only at high concentrations (>250 nM). Both types of QDs were internalized via clathrin-dependent endocytosis. Using real-time, live cell imaging, we found that MPA-QDs interact with the cell surface within minutes and progress through the endocytic pathway to the lysosomes upon internalization. With the THIO-QDs, the internalization process was slower, but the pathways could not be mapped because of spectroscopic interference caused by QD aggregates. Finally, MPA-QDs were found to associate with cell surface scavenger receptors, while the THIO-QDs did not. This study indicates that the surface charge and aggregation characteristics of QDs change drastically in biological culture conditions and, in turn, influence nanoparticle and cellular interactions.

Silver nanoparticles embedded in zeolite membranes: release of silver ions and mechanism of antibacterial action.

BACKGROUND: The focus of this study is on the antibacterial properties of silver nanoparticles embedded within a zeolite membrane (AgNP-ZM). METHODS AND RESULTS: These membranes were effective in killing Escherichia coli and were bacteriostatic against methicillin-resistant Staphylococcus aureus. E. coli suspended in Luria Bertani (LB) broth and isolated from physical contact with the membrane were also killed. Elemental analysis indicated slow release of Ag(+) from the AgNP-ZM into the LB broth. The E. coli killing efficiency of AgNP-ZM was found to decrease with repeated use, and this was correlated with decreased release of silver ions with each use of the support. Gene expression microarrays revealed upregulation of several antioxidant genes as well as genes coding for metal transport, metal reduction, and ATPase pumps in response to silver ions released from AgNP-ZM. Gene expression of iron transporters was reduced, and increased expression of ferrochelatase was observed. In addition, upregulation of multiple antibiotic resistance genes was demonstrated. The expression levels of multicopper oxidase, glutaredoxin, and thioredoxin decreased with each support use, reflecting the lower amounts of Ag(+) released from the membrane. The antibacterial mechanism of AgNP-ZM is proposed to be related to the exhaustion of antioxidant capacity. CONCLUSION: These results indicate that AgNP-ZM provide a novel matrix for gradual release of Ag(+).

Fenton activity and cytotoxicity studies of iron-loaded carbon particles.

The chemical and biological properties of iron-loaded manufactured carbon nanoparticles (Flammruss 101) were contrasted with those of an iron-loaded synthetic carbon particle. X-ray photoelectron spectroscopy was used to characterize the iron on the carbon particles. Production of hydroxyl free radicals via the Fenton reaction was monitored by electron paramagnetic resonance spectroscopy. The iron-loaded synthetic carbon particles produced a positive Fenton response, whereas the iron-loaded manufactured carbon particles did not. The source of the Fenton activity of the synthetic carbon particles is proposed to be a soluble iron compound that was formed during the synthesis of the particle. A likely candidate for the soluble iron species is Fe2F5, which was synthesized and its properties were examined. Higher toxicity of Fe2F5 toward murine macrophages compared with other simple iron salts was attributed to soluble iron that was stabilized by the fluoride ligand. The cytotoxicity of manufactured carbon particles toward murine macrophages decreased or remained unaltered upon impregnation with iron compounds.

Entrapment of ionic tris(2,2'-bipyridyl) ruthenium(II) in hydrophobic siliceous zeolite: O2 sensing in biological environments.

Synthesis of the ionic dye, tris(2,2'-bipyridyl) ruthenium(II) chloride (Ru(bpy) 3 2+.2Cl (-)) within the supercages of a highly hydrophobic zeolite Y is reported. Use of the neutral precursor Ru(bpy)Cl 2(CO) 2 allowed for high loading levels of Ru(bpy) 3 2+ (1 per 7 and 25 supercages). The emission quenching of the Ru(bpy) 3 2+-zeolite crystals dispersed in polydimethoxysiloxane (PDMS) films by dissolved oxygen in water was examined. The quenching data as a function of oxygen concentration was fit to a linear Stern-Volmer plot ( R2 = 0.98). Using the Stern-Volmer plot as calibration, changes in concentration of dissolved oxygen due to reaction with glucose in the presence of glucose oxidase was monitored. Human monocyte-derived macrophages internalized the submicron-sized Ru(bpy) 3 2+-zeolite crystals, and intracellular oxygen concentrations initiated by zymosan-mediated oxidative burst could be monitored by measuring the emission from Ru(bpy) 3 2+ by confocal fluorescence microscopy.