The role of hypochlorous acid in the management of eye infections: a case series

Bertone, Chiara; Mollicone, Antonella; Russo, Stefano; Sasso, Paola; Fasciani, Romina; Riccardi, Cinzia; Lizzano, Mirella; group, the ALI working

doi:10.7573/dic.2022-3-10

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…Hypochlorous acid (HOCl) has a natural bactericidal propriety since it is generated as a portion of the cytotoxic myeloperoxidase in neutrophils [68]. In vitro studies demonstrated that HOCl triggers oxidation of nucleotides, deactivation of cell enzymes, interruption of cell membranes and prompt cell lysis [69].…”

Section: Hypochlorous Acidmentioning

confidence: 99%

Prophylaxis of Ocular Infection in the Setting of Intraocular Surgery: Implications for Clinical Practice and Risk Management

et al. 2023

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In this review we discuss the role of intraocular surgery preoperative prophylaxis. The correct choice of antimicrobial drug is variable in each surgical setting, according to the available strengths of evidence, the anatomical district involved, and the type of procedure. In the ophthalmic surgical field, there has been a progressive shift from antibiotic formulations, which are known to cause antibiotic resistance, to a new class of antiseptic compounds, which proved to be effective not only against bacteria, but also against fungi, protozoa, and viruses. Among these, povidone-iodine (PVI) is a watersoluble polymer that can form a complex with iodine, and the perioperative application of PVI 5-10% eye drop for 3 min is the gold standard for infection prophylaxis. A new formulation of 0.6% PVI eye drop is a new option for infection prophylaxis in the days before surgery. Chlorhexidine is a biguanide compound, which is a valid alternative with a good safety and efficacy profile and is the antiseptic of choice in patients with iodine allergy. New compounds that are currently being studied include polyhexamethylene biguanide (PHMB), picloxydine, ozone, hypochlorous acid (HOCl), and Biosecur. PHMB is a biguanide polymer that was found to be more effective than PVI in in vitro studies for reducing microorganisms and extending the duration of antisepsis, but to date, there are no formulations available on the market for preoperative ocular surgery in which it is present as main ingredient. Ozone is a molecule with oxidizing effect, which showed interesting preliminary results but is not effective against virus, Staphylococcus aureus and Candida albicans. HOCl has a natural bactericidal propriety but its applicability to prophylaxis of ocular infection in the setting of ocular surgery is not established. Biosecur is a non-toxic organic alcohol-free compound that exhibited

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Section: Hypochlorous Acidmentioning

confidence: 99%

Prophylaxis of Ocular Infection in the Setting of Intraocular Surgery: Implications for Clinical Practice and Risk Management

et al. 2023

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“… 20 The ophthalmic application of hypochlorite for the treatment of blepharitis by reducing the bacterial burden has been proven to be effective. 21 , 22 However, unlike in the skin and eyelid, the dose-dependent toxicity of hypochlorite on HCECs still remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Effects of In Vitro Combination of Nitric Oxide Donors and Hypochlorite on Acanthamoeba castellanii Viability

Park,

Park

2023

Trans. Vis. Sci. Tech.

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Purpose To investigate the combined anti- Acanthamoeba effects of nitric oxide (NO) donors and hypochlorite to maximize amoebicidal outcomes while minimizing damage to human corneal epithelial cells (HCECs). Methods Acanthamoeba castellanii and primary cultured HCECs and keratocytes were treated with sodium hypochlorite (NaOCl), NO donors (sodium nitroprusside [SNP] and sodium nitrite [NaNO 2 ]), or a combination of hypochlorite and NO donors. The viability of A. castellanii , HCECs, and keratocytes was assessed. Minimal inhibitory concentration (MIC) and fractional inhibitory concentration of NaOCl and NO donors were determined. The activation of mammalian targets of rapamycin (mTOR) and ERK and the expression of nitrite reductase and Nrf2 were assessed in HCECs using Western blot analysis. The cysticidal effects of combined NaOCl and NO donors were also evaluated. Results A dose-dependent toxicity was observed in A. castellanii , HCECs, and keratocytes when treated with NaOCl and SNP. The range of tested NaNO 2 concentrations showed no significant toxicity to HCECs; however, dose-dependent toxicity to A. castellanii was observed. The MIC of NaOCl against HCECs and A. castellanii was 8.0 mg/mL. The MIC of NaNO 2 and SNP was 500 mM and 10 mM in both HCECs and A. castellanii , respectively . Weak attenuation of the mTOR and ERK phosphorylation was observed and Nrf2 expression decreased slightly after exposure of HCECs to 2.0 mg/mL NaOCl. For the combination treatment, NaOCl (0.125 mg/mL) was selected based on the safety of HCECs and the toxicity of A. castellanii. A more potent anti- Acanthamoeba effect and HCEC toxicity were observed when NaOCl was combined with SNP rather than NaNO 2 . Conclusions Combined NaOCl and NO donors had a stronger anti- Acanthamoeba effect compared to either drug alone. Translational Relevance This study demonstrates that the combined use of various drugs for the treatment of Acanthamoeba infection can enhance the anti- Acanthamoeba effect while minimizing the toxicity of the individual drug.

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TFOS Lifestyle: Impact of elective medications and procedures on the ocular surface

et al. 2023

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The role of hypochlorous acid in the management of eye infections: a case series

Cited by 4 publications

References 15 publications

Prophylaxis of Ocular Infection in the Setting of Intraocular Surgery: Implications for Clinical Practice and Risk Management

Prophylaxis of Ocular Infection in the Setting of Intraocular Surgery: Implications for Clinical Practice and Risk Management

Effects of In Vitro Combination of Nitric Oxide Donors and Hypochlorite on Acanthamoeba castellanii Viability

TFOS Lifestyle: Impact of elective medications and procedures on the ocular surface

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