Hypochlorous acid produced at the counter electrode inhibits catalase and increases bactericidal activity of a hydrogen peroxide generating electrochemical bandage

Electrochemical HOCl Production Modeling for an Electrochemical Catheter

Hypochlorous acid (HOCl) is a strong oxidizing agent that damages cells by interacting with lipids, nucleic acids, sulfur-containing amino acids, and membrane components. It is an endogenous substance produced by the immune system to protect mammals from pathogens. Previously, we developed an HOCl-generating electrochemical catheter (e-catheter) and demonstrated its ability to prevent central line-associated bloodstream infections. The e-catheter is an electrochemical system consisting of two parts - an e-hub and a tube. Working, counter, and reference electrodes are placed in the e-hub, which contains 0.9% NaCl as an electrolyte. Although a prototype of this device has shown activity against pathogens, it is helpful to understand the factors influencing associated electrochemical/chemical processes to optimize design and efficacy. A mathematical model could predict factors influencing HOCl generation and distribution in the catheter and could aid in optimizing these devices. Here, we developed an Electrochemical Hypochlorous Acid Production (EHAP) model to predict factors influencing electrochemical generation and distribution of HOCl in e-catheters, including polarization time, diffusion of HOCl into the e-catheter, operational voltage, working electrode length, and surface area.

The effect of hypochlorous acid inhalation on the activity of antioxidant system enzymes in rats of different ages

Hypochlorous acid HOCl is an effective disinfectant with a broad spectrum and high rate of microbicidal action. Its use for air treatment can be an effective tool for the prevention and therapy of infectious diseases. In this work, the in vivo study was conducted on 110 Wistar Han rats (12 and 72 weeks old) on the effect of a single inhalation of air containing gaseous HOCl on the activity of antioxidant system enzymes. For this, a special installation was designed to uniformly maintain the concentration of HOCl in the air and regulate it over a wide range. Inhalation exposure was carried out for 4 h at total chlorine concentrations in the air of approximately 2.0 mg/m3 and 5.0 mg/m3, after which the animals were observed for 14 days. The effect of inhalation on the antioxidant system activity varied significantly in animals of different ages. Catalase activity in young rats increased approximately 2-fold on days 1-2 after inhalation, regardless of the HOCl concentration, while in old animals a sharp dose-dependent decrease was initially observed. The glutathione peroxidase activity in animals of both ages increased upon inhalation of air with 5.0 mg/m3 HOCl, and in old animals this was more pronounced; when the HOCl concentration decreased to 2.0 mg/m3, this indicator increased slightly in old rats and remained virtually unchanged in young ones. The glutathione reductase activity when exposed to 2.0 mg/m3 HOCl did not change for both age groups, and with increasing HOCl concentration it increased by 1.5-2.0 times in all animals.

Evaluation of treatment of methicillin-resistant Staphylococcus aureus biofilms with intermittent electrochemically generated H2O2 or HOCl

Chronic wound infections can be difficult to treat and may lead to impaired healing and worsened patient outcomes. Novel treatment strategies are needed. This study evaluated the effects of intermittently produced hydrogen peroxide (H2O2) and hypochlorous acid (HOCl), generated via an electrochemical bandage (e-bandage), against methicillin-resistant Staphylococcus aureus biofilms in an agar membrane biofilm model. By changing the working electrode potential, the e-bandage generated either HOCl (1.5 VAg/AgCl) or H2O2 (-0.6 VAg/AgCl). The degree of biocidal activity of intermittent treatment with HOCl and H2O2 correlated with HOCl treatment time; HOCl treatment durations of 0, 1.5, 3, 4.5, and 6 hours (with the rest of the 6-hour total treatment time devoted to H2O2 generation) resulted in mean biofilm reductions of 1.36 ± 0.2, 2.22 ± 0.16, 3.46 ± 0.38, 4.63 ± 0.74, and 7.66 ± 0.5 log CFU/cm2, respectively, vs. non-polarized controls, respectively. However, application of H2O2 immediately after HOCl treatment was detrimental to biofilm removal. For example, 3 hours HOCl treatment followed by 3 hours H2O2 resulted in a 1.90 ± 0.84 log CFU/cm2 lower mean biofilm reduction than 3 hours HOCl treatment followed by 3 hours non-polarization. HOCl generated over 3 hours exhibited biocidal activity for at least 7.5 hours after e-bandage operation ceased; 3 hours of HOCl generation followed by 7.5 hours of non-polarization resulted in a biofilm cell reduction of 7.92 ± 0.12 log CFU/cm2 vs. non-polarized controls. Finally, intermittent treatment with HOCl (i.e., interspersed with periods of e-bandage non-polarization) for various intervals showed similar effects (approximately 6 log CFU/cm2 reduction vs. non-polarized control) to continuous treatment with HOCl for 3 hours, followed by 3 hours of non-polarization. These findings suggest that timing and sequencing of HOCl and H2O2 treatments are crucial for maximizing biofilm control when using an e-bandage strategy.

Evaluation of Treatment of Methicillin-Resistant Staphylococcus aureus Biofilms with Intermittent Electrochemically-Generated H2O2 or HOCl

Chronic wound infections can be difficult to treat and may lead to impaired healing and worsened patient outcomes. Novel treatment strategies are needed. This study evaluated effects of intermittently produced H2O2 and HOCl, generated via an electrochemical bandage (e-bandage), against methicillin-resistant Staphylococcus aureus biofilms in an agar membrane biofilm model. By changing the working electrode potential, the e-bandage generated either HOCl (1.5 VAg/AgCl) or H2O2 (-0.6 VAg/AgCl). The degree of biocidal activity of intermittent treatment with HOCl and H2O2 correlated with HOCl treatment time; HOCl treatment durations of 0, 1.5, 3, 4.5, and 6 hours (with the rest of the 6 hour total treatment time devoted to H2O2 generation) resulted in mean biofilm reductions of 1.36±0.2, 2.22±0.16, 3.46±0.38, 4.63±0.74 and 7.66±0.5 log CFU/cm2, respectively vs. non-polarized controls, respectively. However, application of H2O2 immediately after HOCl treatment was detrimental to biofilm removal. For example, 3-hours HOCl treatment followed by 3-hours H2O2 resulted in a 1.90±0.84 log CFU/cm2 lower mean biofilm reduction than 3-hours HOCl treatment followed by 3-hours non-polarization. HOCl generated over 3-hours exhibited biocidal activity for at least 7.5-hours after e-bandage operation ceased; 3-hours of HOCl generation followed by 7.5-hours of non-polarization resulted in a biofilm cell reduction of 7.92±0.12 log CFU/cm2 vs. non polarized controls. Finally, intermittent treatment with HOCl (i.e., interspersed with periods of e-bandage non-polarization) for various intervals showed similar effects (approximately 6 log CFU/cm2 reduction vs. non-polarized control) to continuous treatment with HOCl for 3-hours, followed by 3-hours of non-polarization. These findings suggest that timing and sequencing of HOCl and H2O2 treatments are crucial for maximizing biofilm control.

DUAL ACTION ELECTROCHEMICAL BANDAGE OPERATED by a PROGRAMMABLE MULTIMODAL WEARABLE POTENTIOSTAT

Electrochemical bandages (e-bandages) can be applied to biofilm-infected wounds to generate reactive oxygen species, such as hypochlorous acid (HOCl) or hydrogen peroxide (H 2 O 2 ). The e-bandage-generated HOCl or H 2 O 2 kills biofilms in vitro and in infected wounds on mice. The HOCl-generating e-bandage is more active against biofilms in vitro , although this distinction is less apparent in vivo . The H 2 O 2 -generating e-bandage, more than the HOCl-generating e-bandage, is associated with improved healing of infected wounds. A strategy in which H 2 O 2 and HOCl are generated alternately-for dual action-was explored. The goal was to develop a programmable multimodal wearable potentiostat (PMWP) that could be programmed to generate HOCl or H 2 O 2 , as needed. An ultralow-power microcontroller unit managed operation of the PMWP. The system was operated with a 260-mAh capacity coin battery and weighed 4.6 grams, making it suitable for small animal experiments or human use. The overall cost of a single wearable potentiostat was $6.50 (USD). The device was verified using established electrochemical systems and functioned comparably to a commercial potentiostat. To determine antimicrobial effectiveness, PMWP-controlled e-bandages were tested against clinical isolates of four prevalent chronic wound bacterial pathogens, methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Acinetobacter baumannii , and Enterococcus faecium , and one fungal pathogen of emerging concern, Candida auris . PMWP-controlled e-bandages exhibited broad-spectrum activity against biofilms of all study isolates tested when programmed to deliver HOCl followed by H 2 O 2 . These results show that the PMWP operates effectively and is suitable for animal testing.

Research frontiers and hotspots in bacterial biofilm wound therapy: bibliometric and visual analysis for 2012-2022

Background

Bacterial biofilms, which can protect bacteria from host immune response and drug attack, are an important factor in the difficult healing of chronic wound infection, which has become a major problem in medical development. This paper aimed to analyze literature related to bacterial biofilm wound treatment published between 2012 and 2022 using bibliometric and visual analysis.

Methods

Publications related to bacterial biofilm wound treatment from 2012 to 2022 were selected from the Web of Science Core Collection. Microsoft Excel 2021, bibliometrics, CiteSpace6.1, and VOSviewer1.6.18 were used to extract and analyze data.

Results

A total of 940 articles were published between 2012 and 2022, with the United States being the leading country (with 302 papers, 32.13%) and the University of Copenhagen in Denmark being the leading institution (with 26 published articles) in the field. Steven L Percival, a British academic, published the most articles (14). In the field of bacterial biofilm wound treatment, keywords suggested that the research gradually transitioned from lower limb venous ulcer, negative pressure-assisted healing to chronic wound, in-vitro bacterial biological model research, and then to the development of more microscopic and more advanced technologies such as antibacterial activity and nanomaterials. "Nanoparticles", "inhibition/antibacterial", "delivery", "gold nanoparticles", "hydrogel", "wound healing", etc., may become new research hotspots in this field.

Conclusion

There is a lack of specific and effective treatment methods for diagnosing and treating bacterial biofilms in wounds. Through the development of multidisciplinary cooperation, early diagnosis and treatment of bacterial biofilms in wounds can be achieved. These data may provide a useful reference for scholars studying more effective bacterial biofilm wound treatment.