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Benítez-Del-Castillo JM. Liposomal ozonated oil effectiveness in the signs and symptoms of blepharitis in usual clinical practice. Eur J Ophthalmol 2024; 34:678-682. [PMID: 37844600 DOI: 10.1177/11206721231207116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
PURPOSE To analyze the efficacy of liposomal ozonated oil (Ozonest®) treatment, in patients with blepharitis or blepharoconjunctivitis, in improving the signs and symptoms of the pathology. METHODS Exploratory, open-label, prospective, single-arm, pre-post comparative pilot study in usual clinical practice, in 20 patients with blepharitis/blepharoconjunctivitis, receiving treatment with liposomal ozonated oil, one drop in each eye, 4 times a day, for 28 days. Main purpose was to assess whether there was a clinically improvement in the blepharitis specific BLISS questionnaire score. Changes in the 12-item OSDI, in eyelid signs of blepharitis assessed by the physicians were also evaluated among other tests, and there was also a subjective evaluation of the treatment by patients. RESULTS The BLISS score significantly improved from 16.4 before treatment to 11.8 after treatment (p < 0.05). The OSDI score was also significantly improved from 27.5 before treatment to 20.5 after treatment (p < 0.05). All tests conducted before and after treatment showed significant improvement (p < 0.05), except for NIBUT. The treatment received a score of 7 out of 10 by the patients. There were no adverse events in any patient. CONCLUSION Liposomal ozonated oil treatment showed good efficacy in improving the signs and symptoms of blepharitis/blepharoconjunctivitis, satisfaction of patients, and good safety and tolerability.
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Affiliation(s)
- Jose Manuel Benítez-Del-Castillo
- Department of Ophthalmology, Hospital Clínico San Carlos de Madrid, Madrid, Spain
- Universidad Complutense de Madrid, Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Madrid, Spain
- Ocular Surface and Dry Eye Unit, Clínica Rementería, Madrid, Spain
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2
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Shah S, Patel V. Targeting posterior eye infections with colloidal carriers: The case of Ganciclovir. Int J Pharm 2023; 645:123427. [PMID: 37729977 DOI: 10.1016/j.ijpharm.2023.123427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/09/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023]
Abstract
The ocular system, unlike any other human body organ, is a system in which foreign bodies appear quite defenceless in front of the eye. Several infections of the ocular system occur due to various opportunistic conditions. Cytomegalovirus (CMV) is one of the opportunivores that causes several posterior eye infections. Ganciclovir (GCV),9-(2-hydroxy-1-(hydroxymethyl) ethoxymethyl), is aguanine-antiviral agent primarily used to treat CMV diseases. However, the major challenge is of lower bioavailability. Hence, GCV must be dosed repeatedly to enhance drug absorption. but this causes side effects like neutropenia and bone marrow suppression. So, formulators have used alternative formulation strategies such as prodrug formulation and colloidal drug delivery systems. In the prodrug strategy, they attempted to bind various compounds into the parent drug to increase the permeability and bioavailability of GCV. In colloidal drug delivery systems, mucoadhesive microspheres, nanoparticles, Niosome and liposome were employed to extend the drug residence time at the application site. This paper discusses several colloidal carriers combined with GCV to treat opportunistic CMV infection in the posterior ocular system. It reviews the limitations of conventional ocular therapy and explores various novel formulation approaches to improve the ocular bioavailability of GCV in the posterior chamber of the eye.
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Affiliation(s)
- Srushti Shah
- Parul Institute of Pharmacy, ParulUniversity, Gujarat 391760, India.
| | - Vandana Patel
- Krishna School of Pharmacy and Research, KPGU, Gujarat 391240, India
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Gentili V, Strazzabosco G, Salgari N, Mancini A, Rizzo S, Beltrami S, Schiuma G, Casciano F, Alogna A, Passarella D, Davinelli S, Scapagnini G, Medoro A, Rizzo R. Ozonated Oil in Liposome Eyedrops Reduces the Formation of Biofilm, Selection of Antibiotic-Resistant Bacteria, and Adhesion of Bacteria to Human Corneal Cells. Int J Mol Sci 2023; 24:14078. [PMID: 37762377 PMCID: PMC10531138 DOI: 10.3390/ijms241814078] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The recent attention to the risk of potential permanent eye damage triggered by ocular infections has been leading to a deeper investigation of the current antimicrobials. An antimicrobial agent used in ophthalmology should possess the following characteristics: a broad antimicrobial spectrum, prompt action even in the presence of organic matter, and nontoxicity. The objective of this study is to compare the antimicrobial efficacy of widely used ophthalmic antiseptics containing povidone-iodine, chlorhexidine, and liposomes containing ozonated sunflower oil. We determined the minimum inhibitory concentration (MIC) on various microbial strains: Staphylococcus aureus (ATCC 6538), methicillin-resistant Staphylococcus aureus (ATCC 33591), Staphylococcus epidermidis (ATCC 12228), Pseudomonas aeruginosa (ATCC 9027), and Escherichia coli (ATCC 873). Furthermore, we assessed its efficacy in controlling antibiotic resistance, biofilm formation, and bacterial adhesion. All three antiseptic ophthalmic preparations showed significant anti-microbicidal and anti-biofilm activity, with the liposomes containing ozonated sunflower oil with the highest ability to control antibiotic resistance and bacteria adhesion to human corneal cells.
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Affiliation(s)
- Valentina Gentili
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.R.); (S.B.); (G.S.); (A.A.); (R.R.)
| | - Giovanni Strazzabosco
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.R.); (S.B.); (G.S.); (A.A.); (R.R.)
| | - Niccolò Salgari
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (N.S.); (F.C.)
| | - Alessandra Mancini
- Department of Ophthalmology, University of “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Sabrina Rizzo
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.R.); (S.B.); (G.S.); (A.A.); (R.R.)
| | - Silvia Beltrami
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.R.); (S.B.); (G.S.); (A.A.); (R.R.)
| | - Giovanna Schiuma
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.R.); (S.B.); (G.S.); (A.A.); (R.R.)
| | - Fabio Casciano
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (N.S.); (F.C.)
- Laboratory for Advanced Therapeutic Technologies (LTTA), University of Ferrara, 44121 Ferrara, Italy
| | - Andrea Alogna
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.R.); (S.B.); (G.S.); (A.A.); (R.R.)
| | - Daniela Passarella
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (D.P.); (S.D.); (G.S.)
| | - Sergio Davinelli
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (D.P.); (S.D.); (G.S.)
| | - Giovanni Scapagnini
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (D.P.); (S.D.); (G.S.)
| | - Alessandro Medoro
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (D.P.); (S.D.); (G.S.)
| | - Roberta Rizzo
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.R.); (S.B.); (G.S.); (A.A.); (R.R.)
- Laboratory for Advanced Therapeutic Technologies (LTTA), University of Ferrara, 44121 Ferrara, Italy
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Prophylaxis of Ocular Infection in the Setting of Intraocular Surgery: Implications for Clinical Practice and Risk Management. Ophthalmol Ther 2023; 12:721-734. [PMID: 36719608 PMCID: PMC10011360 DOI: 10.1007/s40123-023-00661-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/19/2023] [Indexed: 02/01/2023] Open
Abstract
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 water-soluble 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 bactericidal and fungicidal effect versus all common microorganisms and is currently available as an ocular spray.
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Engelmann AM, Bueno A, Barbosa NV, Machado C, Correa D, Cargnelutti JF, de Andrade CM. Effectiveness of ozonized saline solution in the treatment of Proteus spp. bacterial cystitis. Med Gas Res 2022; 13:155-158. [PMID: 36571382 PMCID: PMC9979206 DOI: 10.4103/2045-9912.350861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Bacterial cystitis is a common clinical problem among cats and dogs and is one of the main reasons for the administration of antimicrobials. This can cause serious damage to public and animal health, as this practice facilitates the selection of bacteria that are multidrug-resistant to antibiotics. In this context, it is urgent to understand and validate therapeutic modalities that complement antimicrobial treatment in cystitis cases. Ozone therapy has been proposed by scientists owing to the various mechanisms of action in a range of pathologies, both in human and animal medicine. This paper describes the bactericidal action of two different protocols of bladder irrigation with ozonized saline solution (59 μg/mL) in a paraplegic canine with recurrent bacterial cystitis caused by Proteus spp. In the first protocol, the bladder instillations were applied once a day for three consecutive days while in the second, successive lavages were performed throughout the day until a significant reduction in the presence of bacteria in the urine sediment. In this study, we were able to demonstrate that repeated bladder instillation within 24 hours was the most effective treatment for Proteus compared to a single instillation on successive days.
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Affiliation(s)
- Ana Martiele Engelmann
- Department of Small Animal Clinic, Veterinary Hospital, Federal University of Santa Maria, Santa Maria, RS, Brazil,Correspondence to: Ana Martiele Engelmann, E-mail:
| | - Andressa Bueno
- Department of Small Animal Clinic, Veterinary Hospital, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Nathalia Viana Barbosa
- Department of Small Animal Clinic, Veterinary Hospital, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Carolina Machado
- Department of Preventive Veterinary Medicine, Health Sciences Center (CCS), Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Diego Correa
- Department of Preventive Veterinary Medicine, Health Sciences Center (CCS), Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Juliana Felipetto Cargnelutti
- Department of Preventive Veterinary Medicine, Health Sciences Center (CCS), Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Cinthia Melazzo de Andrade
- Department of Small Animal Clinic, Veterinary Hospital, Federal University of Santa Maria, Santa Maria, RS, Brazil
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Scaramuzzi M, Maestri A, Campagnoli MF, Coscia A, Reibaldi M. Safety and tolerability of ozonated-oils in liposome eyedrop in preterm eye examination. Minerva Pediatr (Torino) 2022; 74:733-737. [PMID: 36239588 DOI: 10.23736/s2724-5276.22.07063-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Eye examinations for ROP screening in preterm newborns are characterized by two main problems: infection control and poor tear secretion. Therefore, in order to reduce the risk of ocular infection and to protect the ocular surface, netilmicin eye drops are usually used after the exams. The purpose of our study was to evaluate the safety and tolerability of ozonated-oils eyedrops during the eye examination of preterm babies in the screening for ROP, sparing the use of antibiotics eyedrops. METHODS All newborn infants that needed to be screened for ROP were divided into two groups: in group A we used topical netilmicin eye drops and in group B ozonated-oils eyedrops. We looked for any sign of conjunctival injection and chemosis, infectious conjunctivitis, blepharoconjunctivitis, erythema, and edema of the eyelids. RESULTS A total of 162 adverse effects out of 3546 examinations (4,5%) were reported acutely: in group A (1778 examinations), they consisted of 47 reactive conjunctivitis, 3 cases of blepharoconjunctivitis, 30 of eyelids swelling, and 3 infectious conjunctivitis, compared to 39 cases of conjunctival injection, 3 blepharoconjunctivitis, 33 eyelids swelling and 4 infectious conjunctivitis in group B (1768 examinations). No significant differences were found in the comparison of the two groups. CONCLUSIONS Ozonated-oils eyedrops should be considered a valid and safe alternative for the lubrification of the ocular surface and an adjuvant strategy to further minimize the risk of microbial contamination during screening for ROP.
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Affiliation(s)
- Matteo Scaramuzzi
- Department of Ophthalmology, Città della Salute e della Scienza, Turin, Italy -
| | - Andrea Maestri
- Division of Neonatology and NICU, Sant'Anna Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Maria F Campagnoli
- Division of Neonatology and NICU, Sant'Anna Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Alessandra Coscia
- Neonatal Care Unit, Department of Public Health and Paediatric, University of Turin, Turin, Italy
| | - Michele Reibaldi
- Department of Ophthalmology, Città della Salute e della Scienza, Turin, Italy.,Department of Surgical Science, Eye Clinic, University of Turin, Turin, Italy
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Prucha VJ, Egerbacher M, Tichy A, Nell B. Effects of diluted povidone iodine on viability and migration of canine corneal epithelial and stromal cells in tissue culture. Res Vet Sci 2022; 151:1-9. [DOI: 10.1016/j.rvsc.2022.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/19/2022] [Accepted: 04/28/2022] [Indexed: 11/15/2022]
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8
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Grandi G, Cavallo R, Zanotto E, Cipriani R, Panico C, Protti R, Scapagnini G, Davinelli S, Costagliola C. In vitro antimicrobial activity of ozonated oil in liposome eyedrop against multidrug-resistant bacteria. Open Med (Wars) 2022; 17:1057-1063. [PMID: 35795001 PMCID: PMC9175013 DOI: 10.1515/med-2022-0495] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 11/15/2022] Open
Abstract
Bacteria are the most common causative agents of ocular infections. Treatment with topical broad-spectrum antibiotics is recommended in severe cases. However, antibiotic resistance has become a major concern in recent years, although antibiotics are generally effective in treating ocular infections. Antibacterial compound screening is performed to identify alternative therapeutic options to antibiotics. The aim of this study was to assess the in vitro antimicrobial activity of an ophthalmic solution containing ozonated oil. Strains of bacterial species with a multidrug resistance profile, which are responsible for a large proportion of ocular infections, were isolated and selected from different biological samples. The bacterial isolates were cultured, and ozonated oil was used to evaluate the inhibition zones at different time points. The treatment exhibited antibacterial activity against all the tested species. The effect was lower against the strains of Pseudomonas aeruginosa and more evident against Staphylococcus and Streptococcus spp. Our results suggest that the administration of ozonated oil may be a candidate agent to treat some infections of the ocular surface with a potential role in antimicrobial prophylaxis.
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Affiliation(s)
- Giuseppe Grandi
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, 10126, Italy
| | - Rossana Cavallo
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, 10126, Italy
| | - Elisa Zanotto
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, 10126, Italy
| | - Raffaella Cipriani
- Microbiology and Virology Unit, Amedeo di Savoia Hospital, Turin, 10149, Italy
| | - Claudio Panico
- Ophthalmology Unit, Humanitas Gradenigo Hospital, Turin, 10153, Italy
| | - Romolo Protti
- Ophthalmic Unit, Hospital San Biagio, Domodossola, 28845, Italy
| | - Giovanni Scapagnini
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Via V. De Sanctis, s.n.c., Campobasso 86100, Italy
| | - Sergio Davinelli
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Via V. De Sanctis, s.n.c., Campobasso 86100, Italy
| | - Ciro Costagliola
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Via V. De Sanctis, s.n.c., Campobasso 86100, Italy
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Pérez-Santonja JJ, Güell JL, Gris O, Vázquez Dorrego XM, Pellicer E, Benítez-Del-Castillo JM. Liposomal Ozonated Oil in Ocular Infections: A Review of Preclinical and Clinical Studies, Focusing on Its Antiseptic and Regenerative Properties. Clin Ophthalmol 2022; 16:1953-1962. [PMID: 35726319 PMCID: PMC9206455 DOI: 10.2147/opth.s360929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Ozonated oil has shown antimicrobial, anti-inflammatory and regenerative properties that make it useful in the prevention of infectious diseases and also as an adjuvant in wound-healing management. This review brings together most aspects of the use of liposomal ozonated oil for ocular infections and regeneration of the ocular surface. A search was performed in PubMed, Medline, Web of Science and Cochrane Library for studies published by June 2021. Search terms were combined to sort out papers on the properties and use of ozonated oil in ocular infections. A total of 25 publications were selected for this review on the composition, mechanism of action, restorative action, and preclinical and clinical studies of liposomal ozonated oil focused on ocular infections. In patients with complicated corneal pathology, liposomal ozonated oil has been found to restore corneal ulcers and improve keratitis. In patients with ocular pathologies involving inflammation and infections, liposomal ozonated oil has been found to improve and almost completely restore the signs of vernal, granulomatous and even adenoviral conjunctivitis. Liposomal ozonated oil has also been found to be effective in reducing ocular microbial flora. In conclusion, liposomal ozonated oil has an antiseptic and regenerative effect on corneoconjunctival tissues. It has demonstrated efficacy and safety profile for its use in ocular infections and can be considered as a suitable supportive strategy both alone and combined with other antimicrobial agents.
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Affiliation(s)
- Juan J Pérez-Santonja
- Department of Ophthalmology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - José Luis Güell
- Department of Cornea and Refractive Surgery, Institut de Microcirurgia Ocular (IMO), Barcelona, Spain
| | - Oscar Gris
- Department of Cornea and Refractive Surgery, Institut de Microcirurgia Ocular (IMO), Barcelona, Spain
| | | | | | - Jose Manuel Benítez-Del-Castillo
- Department of Ophthalmology, Hospital Clínico San Carlos de Madrid, Madrid, Spain
- Universidad Complutense de Madrid, Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Madrid, Spain
- Clínica Rementería, Madrid, Spain
- Correspondence: Jose Manuel Benítez-Del-Castillo, Hospital Clinico San Carlos, C/ Martin Lagos s/n, Madrid, 28040, Spain, Tel +34 913303000, Fax +34 913941359, Email
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10
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Marchegiani A, Gialletti R, Cassarani MP, Cerquetella M, Attili AR, Lombardo G, Lombardo M, Spaterna A, Arcelli R. Riboflavin/UV-A corneal phototherapy as stand-alone management of ulcerative keratitis in dogs. VET MED-CZECH 2022; 67:190-198. [PMID: 39170804 PMCID: PMC11334441 DOI: 10.17221/46/2021-vetmed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 12/13/2021] [Indexed: 08/23/2024] Open
Abstract
Corneal ulcers are one of the most common ocular disorders in veterinary ophthalmology and several factors can negatively influence the efficacy of the currently available therapeutic options, leading to a loss of corneal transparency and, thus, vision. Twenty-five dogs with clinical signs of corneal ulcers were randomised to receive either corneal phototherapy (16 dogs; study group) or topical standard medical therapy (9 dogs; control group). The riboflavin/UV-A corneal phototherapy (PACK-CXL) consisted in the application of a riboflavin ophthalmic solution (Visioflavin®; Vision Engineering Italy srl, Rome, Italy) onto the cornea for 20 min followed by 30 mW/cm2 UV-A irradiance for 3 min using a point-of-care UV-A device (Vetuvir®; Vision Engineering Italy srl, Rome, Italy). The complete healing of the ulcerative lesion was defined as the complete restoration of the corneal epithelial integrity with negative fluorescein staining. The corneal phototherapy achieved complete corneal healing in all the dogs by 20.5 ± 7.8 days. In the control group, only two dogs achieved complete healing by 21.5 ± 15.6 days. This intervention may represent a valid option to hasten corneal wound healing and a clinical resolution of ulcerative keratitis in dogs.
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Affiliation(s)
- Andrea Marchegiani
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica (Macerata), Italy
| | - Rodolfo Gialletti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Maria Paola Cassarani
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica (Macerata), Italy
| | - Matteo Cerquetella
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica (Macerata), Italy
| | - Anna Rita Attili
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica (Macerata), Italy
| | - Giuseppe Lombardo
- CNR-IPCF, Istituto per i Processi Chimico-Fisici, Messina, Italy
- Vision Engineering Italy srl, Rome, Italy
| | - Marco Lombardo
- Vision Engineering Italy srl, Rome, Italy
- Studio Italiano di Oftalmologia, Rome, Italy
| | - Andrea Spaterna
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica (Macerata), Italy
| | - Rolando Arcelli
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
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11
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Spadea L, Zanotto E, Cavallo R, Campagna G, Giannico MI, Costagliola C. Effectiveness of liposomal ozonized oil in reducing ocular microbial flora in patients undergoing cataract surgery. J Cataract Refract Surg 2021; 47:1548-1555. [PMID: 33974370 DOI: 10.1097/j.jcrs.0000000000000672] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/02/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the antimicrobial effectiveness of a liposomal ozonized oil solution used as a home therapy in patients undergoing cataract surgery. Antimicrobial efficacy was evaluated as the reduction in the bacterial load of the most common bacteria isolated from cases with endophthalmitis. SETTING 20 Italian experimental centers of the Effectiveness of Liposomal Ozonized oil on Ocular Microbial flora before cataract surgery study group. DESIGN Interventional, nonrandomized, paired-eye designed, phase 4 clinical study. METHODS A total of 174 patients undergoing cataract surgery were divided into 2 groups: the study group (174 eyes) underwent surgery and received an isotonic ophthalmic solution of 0.5% ozonized oil in liposomes plus hypromellose treatment (2 drops 4 times/d), and the control group (174 contralateral eyes) was treated with saline solution. The treatment lasted for 3 days. Subconjunctival swabs were taken from both eyes of each patient at T0 (the day before starting the treatment and 4 days preoperatively) and at T4 (after 3 days of treatment and 10 min preoperatively) and sent to the laboratory within 24 hours of collection for microbiological analysis. RESULTS 30% of 696 swabs taken at T0 were sterile. Contaminated swabs had a high prevalence of coagulase-negative staphylococci, including Staphylococcus epidermidis, and more than 60 different bacterial species were isolated. A significant reduction in microbial load was observed after treatment (>90% of the samples). The microbial load in the control group remained unchanged. CONCLUSIONS Liposomal ozonized oil reduced the microbial burden after topical administration in a large study population.
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Affiliation(s)
- Leopoldo Spadea
- From the Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy (Spadea, Giannico); Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy (Zanotto, Cavallo); Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Rome, Italy (Campagna); Department of Medicine and Health Science "V. Tiberio," University of Molise, Campobasso, Italy (Costagliola)
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12
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Zerillo L, Polvere I, Varricchio R, Madera JR, D'Andrea S, Voccola S, Franchini I, Stilo R, Vito P, Zotti T. Antibiofilm and repair activity of ozonated oil in liposome. Microb Biotechnol 2021; 15:1422-1433. [PMID: 34773386 PMCID: PMC9049609 DOI: 10.1111/1751-7915.13949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/30/2021] [Indexed: 12/19/2022] Open
Abstract
The use of medical devices, such as contact lenses, represents a substantial risk of infection, as they can act as scaffolds for formation of microbial biofilms. Recently, the increasing emergency of antibiotic resistance has prompted the development of novel and effective antimicrobial drugs for biofilm treatment, such as oxidizing agents. The purpose of this study is to investigate the effects of Ozodrop® and Ozodrop® gel, commercial names of ozonated oil in liposomes plus hypromellose, on eradication and de novo formation of biofilms on different supports, such as plastic plates and contact lens. Our results demonstrate that ozonated liposomal sunflower oil plus hypromellose have an excellent inhibitory effect on bacterial viability and on both de novo formation and eradication of biofilms produced on plates and contact lens by Pseudomonas aeruginosa and Staphylococcus aureus. Moreover, we show that Ozodrop® formulations stimulate expression of antimicrobial peptides and that Ozodrop® gel has a strong repair activity on human epithelial cells, suggesting further applications for the treatment of non‐healing infected wounds.
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Affiliation(s)
- Lucrezia Zerillo
- Dipartimento di Scienze e Tecnologie, Università degli Studi del Sannio, Via dei Mulini, Benevento, 82100, Italy
| | - Immacolata Polvere
- Dipartimento di Scienze e Tecnologie, Università degli Studi del Sannio, Via dei Mulini, Benevento, 82100, Italy
| | | | - Jessica Raffaella Madera
- Dipartimento di Scienze e Tecnologie, Università degli Studi del Sannio, Via dei Mulini, Benevento, 82100, Italy
| | - Silvia D'Andrea
- Genus Biotech, Università degli Studi del Sannio, Benevento, Italy
| | - Serena Voccola
- Genus Biotech, Università degli Studi del Sannio, Benevento, Italy.,Consorzio Sannio Tech, Apollosa, Italy
| | | | - Romania Stilo
- Dipartimento di Scienze e Tecnologie, Università degli Studi del Sannio, Via dei Mulini, Benevento, 82100, Italy
| | - Pasquale Vito
- Dipartimento di Scienze e Tecnologie, Università degli Studi del Sannio, Via dei Mulini, Benevento, 82100, Italy.,Genus Biotech, Università degli Studi del Sannio, Benevento, Italy
| | - Tiziana Zotti
- Dipartimento di Scienze e Tecnologie, Università degli Studi del Sannio, Via dei Mulini, Benevento, 82100, Italy.,Genus Biotech, Università degli Studi del Sannio, Benevento, Italy
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13
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Rizzo S, Savastano MC, Bortolotti D, Savastano A, Gambini G, Caccuri F, Gentili V, Rizzo R. COVID-19 Ocular Prophylaxis: The Potential Role of Ozonated-Oils in Liposome Eyedrop Gel. Transl Vis Sci Technol 2021; 10:7. [PMID: 34351367 PMCID: PMC8354035 DOI: 10.1167/tvst.10.9.7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose To assess whether ozonated-oil in liposome eyedrop gel (OED) could be used to prevent the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection in an in vitro infection model. Methods First, we tested the efficacy of OED on in vitro cell regeneration and dry eye resolution in human corneal epithelial cells (hCE-2). Second, we assessed the in vitro anti-SARS-CoV-2 infection efficacy of OED using Vero E6 cells. Tissues were examined to assess different parameters: morphology, histology, and mRNA expression at 24 hours after treatment. Results OED could restore 50% of the scratch in the monolayer of hCE-2 cells in vitro compared with the 25% obtained with phosphate-buffered saline solution (PBS). At 24 hours after treatment with OED, the number of microvilli and the mucin network were restored, as observed using scanning electron microscopy. In Vero E6 cells infected with a primary SARS-CoV-2 strain and treated with OED two times/day, viral replication was found to be inhibited, with a 70-fold reduction observed at 72 hours after infection compared with that under the untreated and PBS-treated conditions. Conclusions SARS-CoV-2 transmission through the ocular surface should not be ignored. Although the prevalence of coronavirus disease 2019 conjunctivitis infection is low, the need for a barrier to prevent possible viral infection is warranted. OED treatment may prevent the risk of SARS-CoV-2 infection after 72 hours of twice-daily applications. Translational Relevance Dry eye condition might be a risk factor for SARS-CoV-2 infection and OED treatment may have a preventive role.
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Affiliation(s)
- Stanislao Rizzo
- Unit of Ophthalmology, "Fondazione Policlinico A Gemelli IRCCS," Rome, Italy.,"Università Cattolica Sacro Cuore", Rome, Italy.,Consiglio Nazionale delle Ricerche (CNR), Istituto di Neuroscienze, Pisa, Italy
| | - Maria Cristina Savastano
- Unit of Ophthalmology, "Fondazione Policlinico A Gemelli IRCCS," Rome, Italy.,"Università Cattolica Sacro Cuore", Rome, Italy
| | - Daria Bortolotti
- University of Ferrara, Department of Chemical, Pharmaceutical and Agricultural Sciences, Ferrara, Italy
| | - Alfonso Savastano
- Unit of Ophthalmology, "Fondazione Policlinico A Gemelli IRCCS," Rome, Italy.,"Università Cattolica Sacro Cuore", Rome, Italy
| | - Gloria Gambini
- Unit of Ophthalmology, "Fondazione Policlinico A Gemelli IRCCS," Rome, Italy.,"Università Cattolica Sacro Cuore", Rome, Italy
| | - Francesca Caccuri
- Department of Microbiology and Virology, "Spedali Civili," Brescia, Italy
| | - Valentina Gentili
- University of Ferrara, Department of Chemical, Pharmaceutical and Agricultural Sciences, Ferrara, Italy
| | - Roberta Rizzo
- University of Ferrara, Department of Chemical, Pharmaceutical and Agricultural Sciences, Ferrara, Italy
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14
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Antimisiaris S, Marazioti A, Kannavou M, Natsaridis E, Gkartziou F, Kogkos G, Mourtas S. Overcoming barriers by local drug delivery with liposomes. Adv Drug Deliv Rev 2021; 174:53-86. [PMID: 33539852 DOI: 10.1016/j.addr.2021.01.019] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/17/2021] [Accepted: 01/23/2021] [Indexed: 12/13/2022]
Abstract
Localized or topical administration of drugs may be considered as a potential approach for overcoming the problems caused by the various biological barriers encountered in drug delivery. The combination of using localized administration routes and delivering drugs in nanoparticulate formulations, such as liposomes, may have additional advantages. Such advantages include prolonged retention of high drug loads at the site of action and controlled release of the drug, ensuring prolonged therapeutic effect; decreased potential for side-effects and toxicity (due to the high topical concentrations of drugs); and increased protection of drugs from possible harsh environments at the site of action. The use of targeted liposomal formulations may further potentiate any acquired therapeutic advantages. In this review we present the most advanced cases of localized delivery of liposomal formulations of drugs, which have been investigated pre-clinically and clinically in the last ten years, together with the reported therapeutic advantages, in each case.
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15
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Sciorsci RL, Lillo E, Occhiogrosso L, Rizzo A. Ozone therapy in veterinary medicine: A review. Res Vet Sci 2020; 130:240-246. [PMID: 32234614 DOI: 10.1016/j.rvsc.2020.03.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022]
Abstract
Ozone (O3) is a triatomic form of oxygen. As O3 rapidly dissociates into water and releases a reactive form of oxygen that may oxidize cells, the gas mixture of O3/O2 is used in medicine. ATP is widely available for cellular activity. O3 can be administered via the systemic and local routes. Although O3 is known as one of the most powerful oxidants, it also promotes antioxidant enzymes. Additionally, it stimulates some of the cells of the immune system and inactivates pathogens, including bacteria, fungi, yeasts, protozoa, and viruses. Owing to these activities, O3 is used to improve several diseases, both in human and in veterinary medicine. Considering the wide scope of O3 application, the aim of this review was to reiterate the mechanisms of action of O3 and its utilization in different mammalian species (bovine, ovine-caprine, equine, canine, porcine).
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Affiliation(s)
- R L Sciorsci
- Department of Veterinary Medicine, University of Bari Aldo Moro, S.P. per Casamassima km. 3, 70010 Valenzano, BA, Italy.
| | - E Lillo
- Department of Veterinary Medicine, University of Bari Aldo Moro, S.P. per Casamassima km. 3, 70010 Valenzano, BA, Italy
| | - L Occhiogrosso
- Department of Veterinary Medicine, University of Bari Aldo Moro, S.P. per Casamassima km. 3, 70010 Valenzano, BA, Italy
| | - A Rizzo
- Department of Veterinary Medicine, University of Bari Aldo Moro, S.P. per Casamassima km. 3, 70010 Valenzano, BA, Italy
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