Silver-Coated Dressing Acticoat Caused Raised Liver Enzymes and Argyria-like Symptoms in Burn Patient

Exploring the cellular antioxidant mechanism against cytotoxic silver nanoparticles: a Raman spectroscopic analysis

Silver nanoparticles (AgNPs) hold great promise for several different applications, from colorimetric sensors to antimicrobial agents. Despite their widespread incorporation in consumer products, limited understanding of the detrimental effects and cellular antioxidant responses associated with AgNPs at sublethal concentrations persists, raising concerns for human and ecological well-being. To address this gap, we synthesized AgNPs of varying sizes and evaluated their cytotoxicity against human dermal fibroblasts (HDF). Our study revealed that toxicity of AgNPs is a time- and size-dependent process, even at low exposure levels. AgNPs exhibited low short-term cytotoxicity but high long-term impact, particularly for the smallest NPs tested. Raman microspectroscopy was employed for in-time investigations of intracellular molecular variations during the first 24 h of exposure to AgNPs of 35 nm. Subtle protein and lipid degradations were detected, but no discernible damage to the DNA was observed. Signals associated with antioxidant proteins, such as superoxide dismutase (SOD), catalase (CAT) and metallothioneins (MTs), increased over time, reflecting the heightened production of these defense agents. Fluorescence microscopy further confirmed the efficacy of overexpressed antioxidant proteins in mitigating ROS formation during short-term exposure to AgNPs. This work provides valuable insights into the molecular changes and remedial strategies within the cellular environment, utilizing Raman microspectroscopy as an advanced analytical technique. These findings offer a novel perspective on the cytotoxicity mechanism of AgNPs, contributing to the development of safer materials and advice on regulatory guidelines for their biomedical applications.

What to Know about Antimicrobial Coatings in Arthroplasty: A Narrative Review

Periprosthetic joint infections (PJIs) are one of the most worrying complications orthopedic surgeons could face; thus, methods to prevent them are evolving. Apart from systemic antibiotics, targeted strategies such as local antimicrobial coatings applied to prosthetics have been introduced. This narrative review aims to provide an overview of the main antimicrobial coatings available in arthroplasty orthopedic surgery practice. The search was performed on the PubMed, Web of Science, SCOPUS, and EMBASE databases, focusing on antimicrobial-coated devices used in clinical practice in the arthroplasty world. While silver technology has been widely adopted in the prosthetic oncological field with favorable outcomes, recently, silver associated with hydroxyapatite for cementless fixation, antibiotic-loaded hydrogel coatings, and iodine coatings have all been employed with promising protective results against PJIs. However, challenges persist, with each material having strengths and weaknesses under investigation. Therefore, this narrative review emphasizes that further clinical studies are needed to understand whether antimicrobial coatings can truly revolutionize the field of PJIs.

Investigation of sex-based differences in the immunotoxicity of silver nanoparticles

The growing application of silver nanoparticles (AgNPs) in consumer, healthcare, and industrial products has raised concern over potential health implications due to increasing exposure. The evaluation of the immune response to nanomaterials is one of the key criteria to assess their biocompatibility. There are well-recognized sex-based differences in innate and adaptive immune responses. However, there is limited information available using human models. The aim was to investigate the potential sex-based differences in immune functions after exposure to AgNPs using human peripheral blood mononuclear cells (PBMCs) and plasma from healthy donors. These functions include inflammasome activation, cytokine expression, leukocyte proliferation, chemotaxis, plasma coagulation, and complement activation. AgNPs were characterized by dynamic light scattering and transmission electron microscopy. Inflammasome activation by AgNPs was measured after 6- and 24-hours incubations. AgNPs-induced inflammasome activation was significantly higher in the females, especially for the 6-hour exposure. No sex-based differences were observed for Ag ions controls. Younger donors exhibited significantly more inflammasome activation than older donors after 24-hours exposure. IL-10 was significantly suppressed in males and females after exposure. AgNPs suppressed leukocyte proliferation similarly in males and females. No chemoattractant effects, no alterations in plasma coagulation, or activation of the complement were observed after AgNPs exposure. In conclusion, the results highlight that there are distinct sex-based differences in inflammasome activation after exposure to AgNPs in human PBMCs. The results highlight the importance of considering sex-based differences in inflammasome activation induced by exposure to AgNPs in any future biocompatibility assessment for products containing AgNPs.

Localized Cutaneous Argyria at the Site of a Prior Melanoma Excision Confirmed by Scanning Electron Microscopy With Energy Dispersive X-ray Analysis

ABSTRACT

Localized cutaneous argyria is a rare condition caused by the accumulation of silver particles in the skin, leading to blue-gray discoloration. Argyria may mimic melanoma and lead to misdiagnosis. We present a patient with a history of melanoma that developed a blue-gray nodule at a prior melanoma graft. The diagnosis was confirmed using scanning electron microscopy and energy dispersive x-ray analysis. These techniques differentiate argyria from melanoma and can be performed on formalin-fixed, paraffin-embedded, tissue sections. Health care providers should be alert that argyria may mimic recurrent melanoma in patients unaware of silver exposure.

Enhanced healing of wounds that responded poorly to silver dressing by copper wound dressings: Prospective single arm treatment study

Background and Aims

Dressings containing silver ions are an accepted and common option for wound treatment. However, some wounds fail to heal at the desired rate despite optimal management. The aim of the study was to examine the effect of copper dressings in noninfected wounds.

Methods

The study included 20 patients aged 18-85 years with 2-30 cm2 noninfected wounds treated for 17-41 days with silver wound dressings that failed to reduce by >50% the wound size, who were then treated with copper dressings. Ten patients were diabetics, 10 suffered from hypertension, and six suffered from peripheral vascular disease (PVD). Two patients suffered from two wounds. Most were amputation wounds below the knee.

Results

Five patients dropped out from the study due to complications not related to the wound. The mean period of silver and copper dressings treatment was 25.6 and 29.6 days, respectively (p = 0.25; t test). None of the wounds became infected. Comparing a period of 25 days, during the copper dressings treatment, the mean wound area reduction was ~2.4 times higher than during the silver dressing treatment, 87.35 ± 22.4% versus 37.02 ± 25.11% (mean ± SD; p < 0.001; paired t test), respectively. The average decline during the silver and copper treatments were 1.2% and 2.14% per day (p = 0.002; multiple regression analysis), respectively.

Conclusions

The enhanced wound healing process observed with the copper dressings may be explained by the integral role of copper throughout all physiological skin repair processes. Silver in contrast has no physiological role in wound healing. The results of our study confirm case reports showing enhanced wound healing of hard-to-heal wounds with copper dressings, both of infected and noninfected wounds. Taken together, the results of the current study support the hypothesis that the application of copper dressings in situ for noninfected wounds results in the stimulation of the wound healing processes, as opposed to silver dressings.

Antibacterial efficiency over time and barrier properties of wood coatings with colloidal silver

This work aims to represent a standard application for understanding the extent of the antibacterial efficacy of coatings with different amounts of colloidal silver on wooden surfaces over time. The key variable that was intended to be evaluated in this study was the "time efficiency," with concerns about the possible efficacy in the durability of the surfaces. By highlighting the "expiry date" of the agents, as in the case with other products, the study aimed to confirm the validity of the simulation tests conducted in the laboratory with degradation tests. Furthermore, the role of the silver amount on the barrier performance of the coatings was assessed by liquid resistance, water uptake, and perspiration tests, evaluating the aesthetic durability of the coatings by means of colorimetric analyses. Ultimately, this work demonstrates that these coatings may represent alternatives in terms of prolonged antimicrobial activity when compared with the biocide agents currently in use, capable to offer good resistance to detergent solutions and to water. Nevertheless, due to silver's susceptibility to extended exposure to acidic solutions, the findings of the research discourage the utilization of colloidal silver in wood paints intended for use in public settings. KEY POINTS: • Colloidal silver does not alter the deposition process and does not introduce defects in the wood paint. • Coatings containing silver show high antimicrobial activity over time, against both E.coli and S.aureus. • The silver-based filler resists contact with detergents and aqueous solutions but suffers oxidation processes in acidic environments.

Green Synthesis of Silver Nanoparticles Loaded Hydrogel for Wound Healing; Systematic Review

Wound healing is a biological process that involves a series of consecutive process, and its impairment can lead to chronic wounds and various complications. Recently, there has been a growing interest in employing nanotechnology to enhance wound healing. Silver nanoparticles (AgNPs) have expanded significant attention due to their wide range of applications in the medical field. The advantages of AgNPs include their easy synthesis, change their shape, and high surface area. Silver nanoparticles are very efficient for topical drug administration and wound healing because of their high ratio of surface area to volume. The efficiency of AgNPs depends on the synthesis method and the intended application. Green synthesis methods offer an eco-friendly approach by utilizing natural sources such as plant extracts and fungus. The characterization of nanoparticles plays an important character, and it is accomplished through the use of several characterization methods such as UV-Vis spectroscopy, Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and X-ray diffraction (XRD). These techniques are employed to confirm the specific characters of the prepared Silver Nanoparticles. Additionally, the review addresses the challenges and future perspectives of utilizing green-synthesized AgNPs loaded in Polyacrylamide hydrogel for wound healing applications, including the optimization of nanoparticle size, and release kinetics. Overall, this review highlights the potential of green-synthesized AgNPs loaded in Polyacrylamide hydrogel as promising for advanced wound healing therapies. There are different approaches of usage of AgNPs for wound healing such as polyacrylamide -hydrogels, and the mechanism after their antibacterial action, have been exposed.

Exploring the multifunctional roles of quantum dots for unlocking the future of biology and medicine

With recent advancements in nanomedicines and their associated research with biological fields, their translation into clinically-applicable products is still below promises. Quantum dots (QDs) have received immense research attention and investment in the four decades since their discovery. We explored the extensive biomedical applications of QDs, viz. Bio-imaging, drug research, drug delivery, immune assays, biosensors, gene therapy, diagnostics, their toxic effects, and bio-compatibility. We unravelled the possibility of using emerging data-driven methodologies (bigdata, artificial intelligence, machine learning, high-throughput experimentation, computational automation) as excellent sources for time, space, and complexity optimization. We also discussed ongoing clinical trials, related challenges, and the technical aspects that should be considered to improve the clinical fate of QDs and promising future research directions.

Organ distribution of Nano-WC particles after repeated intratracheal instillation into the lungs of SD rats and subsequent organ injury

Nano-tungsten carbide (nano-WC) is widely used in composite materials due to its special physical and chemical properties. Owing to their small size, nano-WC nanoparticles easily enter organisms through the respiratory tract, which may cause health hazards. However, only a few studies have reported the toxicity of nano-WC. In this study, a 10 mg/kg nano-WC suspension and 0.9% normal saline were quantitatively perfused into the lungs of two groups of healthy male SD rats by tracheal instillation, and the in vivo pulmonary toxic effects were systematically evaluated. Additionally, as multiple organs and tissues are involved, systemic effects were observed throughout the body and mainly manifested as inflammatory damage. The concentrations of tungsten ions in various organs and alveolar lavage fluid were measured by ICP-MS, and the results showed that the lung was the target organ, as it had the highest concentration of ions. In addition, the abnormal increases in the tungsten ion concentrations in the liver and kidney may be closely related to the immune damage we observed. This study provides a theoretical basis and data support for the systematic evaluation of the health hazards of nano-WC and a reference for the safe use of nanomaterials.

Anthracene benzene conjugate (ABC): An asymmetric Schiff base for the selective detection of Ag+ ion using fluorimetry and its applications

Anthracene based chemosensor ABC has been synthesized and characterized through ¹H, ¹³C NMR, mass spectral studies. UV absorption and emission studies performed to identify the sensing behavior of chemosensor ABC. The probe ABC, originally bright fluorescent, selectively sense Ag⁺ ion by the quenching the fluorescence intensity through a "Switch On-off" process and quench the fluorescence due to the heavy atom effect interaction with the free chemosensor. The binding constant of the probe ABC with Ag⁺ was calculated as 5.4 × 10⁴ M^-1 and the limit of detection upto 1.4 nM level. The practical utilization of the probe ABC was demonstrated by applying to the real water and soil sample analysis, latent finger print, and the sensor as a fluorescent ink.

Using inorganic nanoparticles to fight fungal infections in the antimicrobial resistant era

Fungal infections pose a serious threat to human health and livelihoods. The number and variety of clinically approved antifungal drugs is very limited, and the emergence and rapid spread of resistance to these drugs means the impact of fungal infections will increase in the future unless alternatives are found. Despite the significance and major challenges associated with fungal infections, this topic receives significantly less attention than bacterial infections. A major challenge in the development of fungi-specific drugs is that both fungi and mammalian cells are eukaryotic and have significant overlap in their cellular machinery. This lack of fungi-specific drug targets makes human cells vulnerable to toxic side effects from many antifungal agents. Furthermore, antifungal drug resistance necessitates higher doses of the drugs, leading to significant human toxicity. There is an urgent need for new antifungal agents, specifically those that can limit the emergence of new resistant species. Non-drug nanomaterials have primarily been explored as antibacterial agents in recent years; however, they are also a promising source of new antifungal candidates. Thus, this article reviews current research on the use of inorganic nanoparticles as antifungal agents. We also highlight challenges facing antifungal nanoparticles and discuss possible future research opportunities in this field. STATEMENT OF SIGNIFICANCE: Fungal infections pose a growing threat to human health and livelihood. The rapid spread of resistance to current antifungal drugs has led to an urgent need to develop alternative antifungals. Nanoparticles have many properties that could make them useful antimycotic agents. To the authors' knowledge, there is no published review so far that has comprehensively summarized the current development status of antifungal inorganic nanomaterials, so we decided to fill this gap. In this review, we discussed the state-of-the-art research on antifungal inorganic nanoparticles including metal, metal oxide, transition-metal dichalcogenides, and inorganic non-metallic particle systems. Future directions for the design of inorganic nanoparticles with higher antifungal efficacy and lower toxicity are described as a guide for further development in this important area.

Potential side effects of antibacterial coatings in orthopaedic implants: A systematic review of clinical studies

Objective: The systematic review aimed to determine the potential side effects of antibacterial coatings in orthopaedic implants. Methods: Publications were searched in the databases of Embase, PubMed, Web of Science and Cochrane Library using predetermined keywords up to 31 October 2022. Clinical studies reporting side effects of the surface or coating materials were included. Results: A total of 23 studies (20 cohort studies and three case reports) reporting the concerns about the side effects of antibacterial coatings were identified. Three types of coating materials, silver, iodine and gentamicin were included. All of studies raised the concerns regarding safety of antibacterial coatings, and the occurrence of adverse events was observed in seven studies. The main side effect of silver coatings was the development of argyria. For iodine coatings, only one anaphylactic case was reported as an adverse event. No systemic or other general side effects were reported for gentamicin. Conclusion: Clinical studies on the side effects of antibacterial coatings were limited. Based on the available outcomes, the most reported side effects of antibacterial coatings in clinical use were argyria with silver coatings. However, researchers should always pay attention to the potential side effects of antibacterial materials, such as systematic or local toxicity and allergy.

Chemical Synthesis of Innovative Silver Nanohybrids with Synergistically Improved Antimicrobial Properties

Background

The wide use of antibiotics has created challenges related to antibiotic-resistant bacteria, which have been increasingly found in recent decades. Antibiotic resistance has led to limited choices of antibiotics. Multiple old antimicrobial agents have high antimicrobial properties toward bacteria, but they unfortunately also possess high toxicity toward humans. For instance, silver (Ag) compounds were frequently used to treat tetanus and rheumatism in the 19th century and to treat colds and gonorrhea in the early 20th century. However, the high toxicity of Ag has limited its clinical use.

Purpose

We aimed to reformulate Ag to reduce its toxicity toward human cells like osteoblasts and to optimize its antimicrobial properties.

Results

Ag, an old antimicrobial agent, was reformulated by hybriding nanomaterials of different dimensions, and silver nanoparticles (AgNPs) of controllable sizes (95-200 nm) and varying shapes (cube, snowflake, and sphere) were synthesized on carbon nanotubes (CNTs). The obtained AgNP-CNT nanohybrids presented significantly higher killing efficacy against Staphylococcus aureus (S. aureus) compared to AgNPs at the same molar concentration and showed synergism in killing S. aureus at 0.2 and 0.4 mM. AgNPs presented significant osteoblast toxicity; in contrast, AgNP-CNT nanohybrids demonstrated significantly enhanced osteoblast viability at 0.04-0.8 mM. The killing of S. aureus by AgNP-CNT nanohybrids was fast, occurring within 15 min.

Conclusion

Ag was successfully reformulated and Ag nanohybrids with various AgNP shapes on CNTs were synthesized. The nanohybrids presented significantly enhanced antimicrobial properties and significantly higher osteoblast cell viability compared to AgNPs, showing promise as an innovative antimicrobial nanomaterial for a broad range of biomedical applications.

Studies of Mercaptosuccinic Acid-Crosslinked Chitosan Hydrogel with Grafted Cinnamaldehyde and Silver Nanoparticles for Antibacterial Biomedical Application

For the effective clinical antibacterial application of biomaterials, such as for wound management and tissue repair, the biomaterials need to show proper antibacterial capability as well as non-cytotoxicity. Furthermore, the material needs to have suitable mechanical characteristics for further medical use. Chitosan hydrogel is a potential candidate for various antibacterial biomedical applications due to its amine functionalities that lead to antimicrobial characteristics. Nevertheless, its antimicrobial capability is dependent upon the degree of protonation of amine groups caused by the pH value. Moreover, its mechanical compressive strength may not be high enough for clinical use if not chemically or physically crosslinked. This study utilized a novel chemical crosslinker, mercaptosuccinic acid, to improve its mechanical characteristics. The natural antibacterial agent, cinnamaldehyde, was grafted onto the crosslinked chitosan to improve its antimicrobial capability. Meanwhile, to take advantage of the thiol functionality in the mercaptosuccinic acid, the bactericidal silver nanoparticles were incorporated through silver-thiol covalent bounding. NMR analyses indicated the chitosan was successfully mercaptosuccinic acid-crosslinked and grafted with cinnamaldehyde at different ratios. Combined the results from the mechanical assessment, swelling experiments, antimicrobial assessment, and cytotoxicity assay, the chitosan hydrogel with the highest crosslinked degree and grafted with cinnamaldehyde and silver nanoparticles is of great promise for further clinical uses.

Changes in Gut Microbiota Structure: A Potential Pathway for Silver Nanoparticles to Affect the Host Metabolism

Silver nanoparticles (AgNPs) are one of the most widely used NPs. Their adverse effects on either the host or its gut microbiota (GM) have been examined. Nevertheless, whether the GM plays any role in AgNP toxicity to the host remains unclear. In the present study, AgNPs were administered to mice by oral gavage once a day for 120 days. A significant dose-dependent accumulation of Ag in the liver was observed, with a steady state reached within 21 days. The AgNPs changed the structure of the GM, mainly with respect to microorganisms involved in the metabolism of energy, amino acids, organic acids, and lipids, as predicted in a PICRUST analysis. Effects of the AgNPs on liver metabolism were also demonstrated, as a KEGG pathway analysis showed the enrichment of pathways responsible for the metabolism of amino acids, purines and pyrimidine, lipids, and energy. More interestingly, the changes in GM structure and liver metabolism were highly correlated, evidenced by the correlation between ∼23% of the differential microorganisms at the genus level and ∼60% of the differential metabolites. This implies that the metabolic variations in liver as affected by AgNPs were partly attributable to NP-induced changes of GM structure. Therefore, our results demonstrate the importance of considering the roles of GM in the toxicity of NPs to the host in evaluations of the health risks of NPs.

Long-term changes in serum silver concentrations after extremity reconstruction with silver-coated megaprostheses

Silver-coated megaprostheses are considered to reduce infection rate following reconstruction of bone defects in tumour surgery or revision arthroplasty. However, little is known about systemic silver exposure and possible side effects. The aim of this study was to analyse serum silver concentrations in patients with silver-coated megaprostheses over a prolonged time period. Between 2004 and 2016, 46 patients (52.2% female, mean age at surgery 47.1 ± 24.2 years) received silver-coated megaprostheses for septic (n = 26) or oncological (n = 17; main implant since 2013) indications, or aseptic loosening (n = 3). Blood was drawn from all patients within the first few days following surgery (without silver ion levels) and thereafter every 6 months at the outpatient department (with silver ion levels). Inductively coupled plasma mass spectrometry was used to determine silver ion levels. Median follow-up was 47.3 months (IQR: 16.1–78.9). Overall, 29 revision surgeries became necessary in 20 patients, equivalent to a cumulative complication rate of 63.0%. Revisions were most commonly for periprosthetic joint infections (PJIs, n = 12) and instability/soft tissue problems (n = 10). Revision-free implant survival was 81.4%, 42.3% and 35.2% at one, 5 and 10 years. Incidence of local argyria was 8.7% (n = 4). Silver ion levels at two or more consecutive time points during follow-up were available for 26 patients. An increment of silver levels within the first months (“run-in”) was observed, followed by an unspecific undulating course. Median initial and latest follow-up (median, 49.5 months) serum silver ion levels were 16.0 ppb (IQR: 9.1–29.1) and 7.4 ppb (IQR: 2.7–14.1), respectively. According to the multivariate mixed linear random-effects model, development of PJI was associated with significantly higher silver ion levels over time (p = 0.002), irrespective of time from surgery (p = 0.274). In the current series, a cumulative complication rate of 63.0% was observed for patients receiving silver-coated megaprostheses for septic of oncological indications. An overall unspecific course of silver ion concentration was present. Development of PJI was significantly associated with increased silver ion levels over time. Yet, no systemic complication associated to high silver levels occurred. It can be concluded that silver-coated implants constitute a safe solution for megaprosthetic reconstruction, but monitoring of silver concentrations is recommended.

Innovative Codeposition of a Ag-Al2O3 Layer: An Attractive Combination of High Durability and Lack of Cytotoxicity for Public Space Applications

Today, the use of silver in surfaces for public environments is very frequent, as it ensures high antimicrobial activities, avoiding the continuous disinfection of the surfaces themselves. Similarly, thanks to its interesting combination of technological properties, anodized aluminum is widely employed in the production of components for applications in public spaces. Therefore, this work describes a simple method of the codeposition of silver and anodized aluminum to combine the remarkable properties of Al₂O₃ layers with the antibacterial performances of silver. The effect of silver in modifying the durability features of the anodized aluminum layer was evaluated by means of various accelerated degradation techniques, such as the exposure in a climatic chamber to UV-B radiation or an aggressive atmosphere simulated by the Kesternich test. These analyses showed the good compatibility between Ag and the alumina matrix, whose durability performances were not particularly influenced by silver. Furthermore, the composite layers did not express relevant cytotoxicity activity, as evidenced by Trypan blue flow cytometry analysis and microscopy observations, ensuring the possible use of this material in applications in close contact with humans. This same conclusion was reached by observing an almost negligible ionic release of Ag by the composite layers, even following severe degradation of the alumina matrix due to exposure to a particular acid solution. In conclusion, this work presents an innovative material that can be used in public spaces, thanks to its interesting combination of high durability and low cytotoxicity.

Wide Spectrum Potent Antimicrobial Efficacy of Wound Dressings Impregnated with Cuprous Oxide Microparticles

Copper has intrinsic antimicrobial properties. Wound dressings impregnated with cuprous oxide microparticles (hereafter termed COD) have been cleared for the management of acute and chronic wounds by the FDA and other regulatory bodies. The COD reduced the viable microbial titers of a wide spectrum of microbes by more than 10,000-fold (4-logs) within 3 h of exposure at 37 °C (p < 0.001). Similar microbial titer reductions were achieved by 3-year naturally aged COD dressings, showing the stability of the biocidal efficacy over time. The potent biocidal efficacy of the COD was maintained even after 7 daily consecutive inoculations of the dressings with ~106 CFU. COD with an adhesive contour blocked the passage of bacteria from the exterior environment to the wound bed side of the dressing even after 7 daily consecutive inoculations of different bacteria on the outer surface of the dressings. Taken together, the study demonstrates the wide spectrum potent in vitro biocidal efficacy of the cuprous oxide impregnated dressings against a wide panel of microorganisms.

Anti-Colonization Effect of Au Surfaces with Self-Assembled Molecular Monolayers Functionalized with Antimicrobial Peptides on S. epidermidis

Medical devices with an effective anti-colonization surface are important tools for combatting healthcare-associated infections. Here, we investigated the anti-colonization efficacy of antimicrobial peptides covalently attached to a gold model surface. The gold surface was modified by a self-assembled polyethylene glycol monolayer with an acetylene terminus. The peptides were covalently connected to the surface through a copper-catalyzed [3 + 2] azide-acetylene coupling (CuAAC). The anti-colonization efficacy of the surfaces varied as a function of the antimicrobial activity of the peptides, and very effective surfaces could be prepared with a 6 log unit reduction in bacterial colonization.

Nanotechnology Fundamentals Applied to Clinical Infectious Diseases and Public Health

Nanotechnology involves the discovery and fabrication of nanoscale materials possessing unique physicochemical properties that are being employed in industry and medicine. Infectious Diseases clinicians and public health scientists utilize nanotechnology applications to diagnose, treat, and prevent infectious diseases. However, fundamental principles of nanotechnology are often presented in technical formats that presuppose an advanced knowledge of chemistry, physics, and engineering, thereby limiting the clinician’s grasp of the underlying science. While nanoscience is technically complex, it need not be out of reach of the clinical practitioner. The aim of this review is to introduce fundamental principles of nanotechnology in an accessible format, describe examples of current clinical infectious diseases and public health applications, and provide a foundation that will aid understanding of and appreciation for this burgeoning and important field of science.

Use of single particle ICP-MS to estimate silver nanoparticle penetration through baby porcine mucosa

Children are potentially exposed to products that contain nanoparticles (NPs). In particular, silver NPs are commonly present both in products used by and around children, primarily due to their antibacterial properties. However, very few data are available regarding the ability of silver NPs to penetrate through the oral mucosa in children. In the present work, we used baby porcine buccal mucosa mounted on vertical Franz diffusion cells, as an in vitro model to investigate penetration of silver NPs (19 ± 5 nm). Permeability experiments were performed using pristine physiologically-relevant saline solution in the receiver chamber and known concentrations of NPs or ions in the donor chamber; conditions mimicked the in vivo physiological pH conditions. After physicochemical characterization of silver nanoparticles dispersed in physiological solution, we evaluated the passage of ions and NPs through the mucosa, using single particle inductively coupled plasma mass spectrometry. A flux of 4.1 ± 1.7 ng cm^-2min^-1 and a lag time of 159 ± 17 min were observed through mucosa exposed to silver nanoparticles. The latter suggests nanoparticle penetration through the baby porcine mucosa and release Ag⁺ ions in the receptor fluid, as confirmed by computational model. Due to physiological similarity between human and pig membranes it is reasonable to assume that a trans-oral mucosa penetration could occur in children upon contact with silver nanoparticles.

Synthesis and Antibacterial Activity of Metal-Containing Ultraviolet-Cured Wood Floor Coatings

In our previous report, the antibacterial agents with different metals, mono(hydroxyethoxyethyl)phthalate [M(HEEP)₂, M = Zn, Mn, and Ca], were synthesized. For increasing their yields, modified synthesis and purified processes were further investigated. The result of energy-dispersive X-ray spectroscopy showed the M(HEEP)₂ could be stable and successfully synthesized, and their yields were raised to 73–85% from our previous report of 43–55%. For ultraviolet-cured wood floor coating application, the Zn(HEEP)₂ was selected as an antibacterial agent and mixed with commercial UV wood floor coating. The effects on the antibacterial activity of UV films with different Zn(HEEP)₂ additions of 0, 4, 8, and 12 phr as well as the commercial nano-Ag of 12 phr against Escherichia coli were evaluated. In the static antibacterial test, the UV films with Zn(HEEP)₂ additions had similar antibacterial activity of 57–59%. In another dynamic shaking antibacterial test, the film containing 12 phr Zn(HEEP)₂ had the best antibacterial activity among all the UV films. On the film properties, the Zn(HEEP)₂-containing UV films had lower gloss and abrasion resistance, and slightly increased the hardness than those of UV film without Zn(HEEP)₂ addition. However, there were no noticeable differences in mass retention, lightfastness, and thermal stability between UV films with and without the Zn(HEEP)₂ addition. In this study, the 12 phr Zn(HEEP)₂-containing UV film provided the best antibacterial activity against E. coli and had the balanced film properties for application on the UV wood floor coating.

High silver concentrations in biological samples following different exposures: Two case reports

BACKGROUND

Silver is used in various industrial applications, but also in confectioneries and for therapeutic use due to its antibiotic properties. Its toxicity is not well documented and most often only in the context of professional exposure.

AIM

Here we report two cases of high silver concentrations in biological samples in two women: the first patient presented grey marks around her cuticles, probably due to her consumption of silvered sweets and the second patient presented agranulocytosis and thrombocytopenia occurring within 24 h after the topical application of a cream containing sulfadiazine and silver to burns over a large surface area.

METHODS

Silver concentrations were determined in blood and urine samples and sweets using inductively coupled plasma- mass spectrometry (ICP-MS).

RESULTS

The silver concentrations were elevated compared to population reference values and confirmed the hypotheses for the patients: the significant consumption of sweets coated with silver nanoparticles and the topical application of a cream containing silver to burns over a large area.

DISCUSSION-CONCLUSION

After initial questioning by the dermatologist, Patient 1 explained that she consumed more than 30 bags of the sweets per year. She decreased her consumption of the sweets and the control performed one year later showed a plasma silver concentration of 1.5 μg/L. For Patient 2, the absorption of silver through burns over a large area appeared relatively significant, whereas it is very low through undamaged skin. The haematological cells counts returned to normal levels quickly and no other major effects were highlighted. To apply these findings to a larger population, further investigation to determine sulfadiazine and silver concentrations in plasma and urine have been initiated in a cohort of patients with burns over a large area.

The Antimicrobial Properties of Modified Pharmaceutical Bentonite with Zinc and Copper

Pharmaceutical grade bentonite, containing a high amount of montmorillonite, enriched with zinc (Zn) or copper (Cu) (ZnBent and CuBent, respectively) was used as the main component for the creation of formulations for cutaneous use and tested for their antimicrobial capacity. Bentonite (Bent) with added phenoxyethanol (PH) as a preservative and unmodified bentonite were used as control groups. The mineralogical composition, structural state, and physical or chemical properties, before and after the modification of the samples, were characterized utilizing X-ray Diffraction Analysis (XRD), Fourier-Transform Infrared Spectroscopy (FTIR) and X-ray Fluorescence (XRF) techniques, and Scanning Electron Microscope-Energy Dispersive Spectroscopy (SEM, SEM-EDS) analyses. In addition, the profile of zinc and copper concentration from two types of surfaces ZnBent and CuBent, and into Phosphate-Buffered Saline (PBS) are discussed. Finally, the formulations in the form of basic pastes were challenged against bacteria, molds, and yeasts, and their performance was evaluated based on the European Pharmacopeia criteria. The Cu-modified bentonite performed excellently against bacteria and yeasts, while the Zn-modified bentonite only showed great results against yeasts. Therefore, Cu-modified bentonite formulations could offer antimicrobial protection without the use of preservatives.

Application of nanotized formulation in the control of snail intermediate hosts of schistosomes

Schistosomiasis continues to pose significant public health problems in many developing countries. Mass drug administration (MDA) is the most adopted control option but there is increasing evidence for the development of praziquantel-resistant Schistosoma strains. This shortcoming has necessitated the search for other effective methods for the control of schistosomiasis. The breaking of Schistosoma transmission cycles through the application of molluscicides into snail infested freshwater bodies has yielded positive outcomes when integrated with MDA in some countries. However, few of such effective molluscicides are currently available, and where available, their application is restricted due to toxicity concerns. Some nanotized particles with molluscicidal activities against the different stages of snail intermediate hosts of schistosomes have been reported. Importantly, the curcumin-nisin nanoparticle synthesized by our group was very effective and it showed no significant toxicity in a mouse model and brine shrimps. This, therefore, offers the possibility of developing a molluscicide that is not only safe for man but also is environmentally friendly. This paper reviews nanoparticles with molluscicidal potential. The methods of their formulation, activities, probable mechanisms of actions, and their toxicity profiles are discussed. More research should be made in this field as it offers great potential for the development of new molluscicides.

In vitro coronal protein signatures and biological impact of silver nanoparticles synthesized with different natural polymers as capping agents

Biopolymer-capped particles, sodium alginate-, gelatin- and reconstituted silk fibroin-capped nanosilver (AgNPs), were synthesized with an intention to study, simultaneously, their in vitro and in vivo haemocompatibility, one of the major safety factors in biomedical applications. Solid state characterization showed formation of spherical nanoparticles with 5 to 30 nm primary sizes (transmission electron microscopy) and X-ray photoelectron spectroscopy analysis of particles confirmed silver bonding with the biopolymer moieties. The degree of aggregation of the biopolymer-capped AgNPs in the synthesis medium (ultrapure water) is relatively low, with comparable hydrodynamic size with those of the control citrate-stabilized NPs, and remained relatively unchanged even after 6 weeks. The polymer-capped nanoparticles showed different degrees of aggregation in biologically relevant media - PBS (pH 7.4) and 2% human blood plasma - with citrate- (control) and alginate-capped particles showing the highest aggregation, while gelatin- and silk fibroin-capped particles revealed better stability and less aggregation in these media. In vitro cytotoxicity studies revealed that the polymer-capped particles exhibited both concentration and (hydrodynamic) size-dependent haemolytic activity, the extent of which was higher (up to 100% in some cases) in collected whole blood samples of healthy human volunteers when compared to that in the washed erythrocytes. This difference is thought to result from the detected protein corona formation on the nanoparticle surface in the whole blood system, which was associated with reduced particle aggregation, causing more severe cytotoxic effects. At the tested particle concentration range in vitro, we observed a negligible haemolysis effect in vivo (Balb/c mice). Polymer-capped particles did accumulate in organs, with the highest levels detected in the liver (up to 422 μg per g tissue), yet no adverse behavioural effects were observed in the mice during the duration of the nanoparticle exposure.

Silver distribution in chronic wounds and the healing dynamics of chronic wounds treated with dressings containing silver and octenidine

Although silver is an efficient antimicrobial and is a widely used antiseptic in wound healing, previous studies have reported the cytotoxic in vitro effects of silver dressings. Moreover, few studies have addressed the distribution of silver in chronic wounds. The study compares the healing of chronic wounds treated with a standard-of-care silver dressing (Ag-CMC) and a dressing containing antiseptic octenidine (OCT-HA). Biopsies were taken from two wound areas before the commencement of treatment (baseline), after 2 weeks and after 6 weeks (the end of the study). We analyzed the histopathologic wound-healing score, silver distribution, and expression of selected genes. The wound-healing score improved significantly in the wounded area treated with OCT-HA after 2 weeks compared to the baseline and the Ag-CMC. The Ag-CMC wound areas improved after 6 weeks compared to the baseline. Moreover, collagen maturation and decreases in the granulocyte and macrophage counts were faster in the OCT-HA parts. Treatment with OCT-HA resulted in less wound slough. The silver, visualized via autometallography, penetrated approximately 2 mm into the wound tissue and associated around capillaries and ECM fibers, and was detected in phagocytes. The metallothionein gene expression was elevated in the Ag-CMC wound parts. This exploratory study determined the penetration of silver into human chronic wounds and changes in the distribution thereof during treatment. We observed that silver directly affects the cells in the wound and elevates the metallothionein gene expression. Octenidine and hyaluronan dressings provide a suitable alternative to silver and carboxymethyl cellulose dressings without supplying silver to the wound.

Histopathological Changes of Organs (Lungs, Liver, Kidney, and Brain) After Using Two Types of AgiCoat and Acticoat Nanosilver Dressings on Deep Second-Degree Burn in Rat

Prevention of infections is a very important issue in treating the burn wounds. The nanosilver dressings have many promising advantages, but absorption of silver ions and its adverse effects to the body were always a question. The aim of this study was to compare Silver serum levels and acute toxic effects of nanosilver on histopathology of organs (lungs, liver, kidney, spleen, and brain) in two types of AgiCoat and Acticoat (nanosilver) dressings on second-degree deep burn in rat. This is an experimental study conducted in our animal laboratory. We divided 24 Sprague-Dawley male rats weighing 300 to 350 randomly into two groups. After anesthesia, a second deep-degree burn was made over dorsal skins of rats by standard method. For group A, Agicoat and, for group B, Acticoat dressings were used. The dressings were changed every 3 days with AgiCoat and Acticoat, respectively. After 14 days, we got blood samples and tissue samples taken from heart, liver, kidneys, spleen, lungs, and brain and a sample from dorsal skin of the rat for histopathological examinations. The results showed that the levels of serum silver in both groups were significantly higher than the standard level (1.22 part per million (PM); AgiCoat, P = .017; Acticoat, P = .000), but there was no significant difference between the groups (P = .551). Examination of the relationship between the level of serum silver and histopathological changes in liver showed that hepatotoxicity of AgiCoat was higher compared with Acticoat and the difference was significant (P = .002). There were no pathological changes in brain, kidneys, spleen, heart, and lungs. Wound healing was faster in Acticoat group. The nanosilver dressings can cause toxicity in liver but not in kidney, brain, spleen, heart, and lungs. Liver pathology and hepatotoxicity were more prominent in AgiCoat group. Wound healing was faster in Acticoat group.

Clinical and Forensic Aspects of the Different Subtypes of Argyria

Argyria encompasses the different cosmetic alterations that can develop if enough silver particles deposit in a specific tissue, typically in the skin, ranging from localized dark-blue macules to a generalized slate-gray/bluish tinge following systemic absorption. This work aims to fully review the state of the art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic features of argyria. Argyria has been diagnosed in a wide range of ages, both sexes and varied ethnicities, with no known individual predisposing factors. Ultraviolet radiation with subsequence increases of melanin production aggravates the discoloration due to a reduction in the silver deposits. Physical examination and silver exposure in the anamnesis can be highly suggestive of the diagnosis, but a histopathological analysis with Energy-Dispersive X-ray Spectroscopy is required to unequivocally determine the discoloration etiology. Safe and effective treatment has only been accomplished with laser techniques, though only a few cases have been reported and with limited follow-up time. In conclusion, argyria typically has an occupational or iatrogenic etiology. It should be suspected when a patient presents with typical skin or eye lesions. A seemingly viable treatment modality, with laser technology, is finally within the horizon.

Green synthesis of silver nanoparticles from aqueous extract of Scutellaria barbata and coating on the cotton fabric for antimicrobial applications and wound healing activity in fibroblast cells (L929)

Scutellaria barbata is a perennial herb which was vastly prescribed in Chinese medicine to treat inflammations, infections and it is also used a detoxifying agent. We synthesized silver nanoparticles with Scutellaria barbata extract and characterized the nanoparticles with UV–Vis spectroscopic analysis, TEM, AFM, FTIR and XRD. The biofilm inhibiting property of synthesized silver nanoparticles were examined with XTT reduction assay and the antimicrobial property was examined with well diffusion method. The silver nanoparticles were also coated with cotton fabrics and their efficacy against antimicrobials was analyzed to prove its application. The cytotoxic property of synthesized silver nanoparticles was examined with L929 fibroblast cells using MTT assay. Finally we analyzed the wound healing property of synthesized silver nanoparticles with wound scratch assay. The result of our UV–Vis spectroscopic analysis confirms Scutellaria barbata aqueous extract reduced silver ions and synthesized silver nanoparticles. The characterization studies TEM, AFM, FTIR and XRD confirms the synthesized silver nanoparticles are in ideal shape and size to be utilized as a drug. The XTT reduction assay proves silver nanoparticles effectively inhibits the biofilm formation in both resistant and sensitive strains. Antimicrobial sensitivity tests confirms synthesized silver nanoparticles and cotton coated synthesized silver nanoparticles both are effective against gram positive, gram negative and fungal species. Further the results of MTT assay confirms the synthesized silver nanoparticles are non toxic and finally the wound healing potency of the nanoparticles was confirmed with wound scratch assay. Over all our results authentically confirms the silver nanoparticles synthesized with Scutellaria barbata aqueous extract is potent wound healing drug.

An antimicrobial peptide-immobilized nanofiber mat with superior performances than the commercial silver-containing dressing

Silver-containing dressings are widely used for the treatment of infected wounds in clinics, but the potential risks of heavy metals are still a common concern. In this study, we prepared a type of electrospun starch nanofiber mat containing the antimicrobial peptide ε-poly-lysine (Starch-EPL) and compared its relevant properties with a representative silver-containing dressing 3M™ Tegaderm™ Alginate Ag (Alginate-Ag). SEM, FTIR and EDAX results show the two samples have similar fiber structures and are loaded with antibacterial agents. The comparison results indicate that the Starch-EPL nanofiber mat has equivalent permeability and absorbency with Alginate-Ag but higher mechanical property and wettability. Moreover, the Starch-EPL nanofiber mat has comparable antibacterial activity against both Gram-negative and Gram-positive bacteria with Alginate-Ag, but markedly better biocompatibility than that. The Starch-EPL nanofiber mat can inhibit the growth of bacteria for at least 14 days by sustainably releasing EPL, showing great potential as a long-term antibacterial dressing. All these results demonstrate that the Starch-EPL nanofiber mat may be a good candidate to replace the traditional silver-containing dressings.

Silver in biology and medicine: opportunities for metallomics researchers

The antibacterial properties of silver have been known for centuries and the threat of antibiotic-resistant bacteria has led to renewed focus on the noble metal. Silver is now commonly included in a range of household and medical items to imbue them with bactericidal properties. Despite this, the chemical fate of the metal in biological systems is poorly understood. Silver(I) is a soft metal with high affinity for soft donor atoms and displays much similarity to the chemistry of Cu(I). In bacteria, interaction of silver with the cell wall/membrane, DNA, and proteins and enzymes can lead to cell death. Additionally, the intracellular generation of reactive oxygen species by silver is posited to be a significant antimicrobial action. While the antibacterial action of silver is well known, bacteria found in silver mines display resistance against it through use of a protein ensemble thought to have been specifically developed for the metal, highlighting the need for judicious use. In mammals, ∼10-20% of ingested silver is retained by the body and thought to predominantly localize in the liver or kidneys. Chronic exposure can result in argyria, a condition characterized by blue staining of the skin, resulting from subdermal deposition of silver [as Ag(0)/sulfides], but more insidious side effects, such as inclusions in the brain, seizures, liver/kidney damage, and immunosuppression, have also been reported. Here, we hope to highlight the current understanding of the biological chemistry of silver and the necessity for continued study of these systems to fill existing gaps in knowledge.

A clinical mimicker of melanoma with distinctive histopathology: Topical silver nitrate exposure

Exposure to silver-containing compounds can result in reversible discoloration of the skin, presenting as an irregular brown or black macule, which can have a clinical appearance similar to melanoma. Both the clinical scenario and the histopathology are unique. Silver nitrate darkens with exposure to light, and the area can appear to change over time. On microscopic examination, there are coarse pigmented granules dispersed throughout the corneal layer, and largely absent from the remainder of the epidermis-although the precise location may depend on the duration of topical exposure. While argyria, its irreversible counterpart, has been well-characterized, only a single source has previously reported the histopathology of transient topical silver nitrate exposure. We present two cases, review the clinical and histopathologic differentials, and detail the distinctive histopathology that enables a diagnosis to be suggested in this clinical mimicker of melanoma.

A tailored positively-charged hydrophobic surface reduces the risk of implant associated infections

Implant-associated infections is one of the most challenging post-operative complications in bone-related implantations. To tackle this clinical issue, we developed a low-cost and durable surface coating for medical grade titanium implants that uses positively charged silane molecules. The in vitro antimicrobial tests revealed that the titanium surface coated with (3-aminopropyl) triethoxysilane, which has the appropriate length of hydrophobic alkyl chain and positive charged amino group, suppressed more than 90% of the initial bacterial adhesion of S. aureus, P. aeruginosa, and E. coli after 30 min of incubation. In terms of growth inhibitory rate, the treated surface was able to reduce 75.7% ± 11.9% of bacterial growth after a 24-hour culturing, thereby exhibiting superior anti-biofilm formation in the late stage. When implanted into the rat model infected by S. aureus, the treated surface eliminated the implant-associated infection through the mechanism of inhibition of bacterial adhesion on the implant surface. Additionally, the treated surface was highly compatible with mammalian cells. In general, our design demonstrated its potential for human clinical trials as a low-cost and effective antibacterial strategy to minimize post-operative implant-related bacterial infection.

Nanometals in Dentistry: Applications and Toxicological Implications-a Systematic Review

Nanotechnology is a vital part of health care system, including the dentistry. This branch of technology has been incorporated into various fields of dentistry ranging from diagnosis to prevention and treatment. The latter involves application of numerous biomaterials that help in restoration of esthetic and functional dentition. Over the past decade, these materials were modified through the incorporation of metal nanoparticles (NP) like silver (Ag), gold (Au), titanium (Ti), zinc (Zn), copper (Cu), and zirconia (Zr). They enhanced antimicrobial, mechanical, and regenerative properties of these materials. However, lately, the toxicological implications of these nanometal particles have been realized. They were associated with cytotoxicity, genotoxicity altered inflammatory processes, and reticuloendothelial system toxicity. As dental biomaterials containing metal NPs remain functional in oral cavity over prolonged periods, it is important to know their toxicological effects in humans. With this background, the present systematic review is aimed to gain an insight into the plausible applications and toxic implications of nano-metal particles as related to dentistry.

Silver Nanomaterials for Wound Dressing Applications

Silver nanoparticles (AgNPs) have recently become very attractive for the scientific community due to their broad spectrum of applications in the biomedical field. The main advantages of AgNPs include a simple method of synthesis, a simple way to change their morphology and high surface area to volume ratio. Much research has been carried out over the years to evaluate their possible effectivity against microbial organisms. The most important factors which influence the effectivity of AgNPs against microorganisms are the method of their preparation and the type of application. When incorporated into fabric wound dressings and other textiles, AgNPs have shown significant antibacterial activity against both Gram-positive and Gram-negative bacteria and inhibited biofilm formation. In this review, the different routes of synthesizing AgNPs with controlled size and geometry including chemical, green, irradiation and thermal synthesis, as well as the different types of application of AgNPs for wound dressings such as membrane immobilization, topical application, preparation of nanofibers and hydrogels, and the mechanism behind their antimicrobial activity, have been discussed elaborately.

Polyarginine Decorated Polydopamine Nanoparticles With Antimicrobial Properties for Functionalization of Hydrogels

Polydopamine (PDA) nanoparticles are versatile structures that can be stabilized with proteins. In this study, we have demonstrated the feasibility of developing PDA/polypeptides complexes in the shape of nanoparticles. The polypeptide can also render the nanoparticle functional. Herein, we have developed antimicrobial nanoparticles with a narrow size distribution by decorating the polydopamine particles with a chain-length controlled antimicrobial agent Polyarginine (PAR). The obtained particles were 3.9 ± 1.7 nm in diameter and were not cytotoxic at 1:20 dilution and above. PAR-decorated nanoparticles have exhibited a strong antimicrobial activity against S. aureus, one of the most common pathogen involved in implant infections. The minimum inhibitory concentration is 5 times less than the cytotoxicity levels. Then, PAR-decorated nanoparticles have been incorporated into gelatin hydrogels used as a model of tissue engineering scaffolds. These nanoparticles have given hydrogels strong antimicrobial properties without affecting their stability and biocompatibility while improving their mechanical properties (modulus of increased storage). Decorated polydopamine nanoparticles can be a versatile tool for the functionalization of hydrogels in regenerative medicine applications by providing bioactive properties.

Evolution of Nanotechnology in Delivering Drugs to Eyes, Skin and Wounds via Topical Route

The topical route is the most preferred one for administering drugs to eyes, skin and wounds for reaching enhanced efficacy and to improve patient compliance. Topical administration of drugs via conventional dosage forms such as solutions, creams and so forth to the eyes is associated with very low bioavailability (less than 5%) and hence, we cannot rely on these for delivering drugs to eyes more efficiently. An intravitreal injection is another popular drug delivery regime but is associated with complications like intravitreal hemorrhage, retinal detachment, endophthalmitis, and cataracts. The skin has a complex structure that serves as numerous physiological barriers to the entry of exogenous substances. Drug localization is an important aspect of some dermal diseases and requires directed delivery of the active substance to the diseased cells, which is challenging with current approaches. Existing therapies used for wound healing are costly, and they involve long-lasting treatments with 70% chance of recurrence of ulcers. Nanotechnology is a novel and highly potential technology for designing formulations that would improve the efficiency of delivering drugs via the topical route. This review involves a discussion about how nanotechnology-driven drug delivery systems have evolved, and their potential in overcoming the natural barriers for delivering drugs to eyes, skin and wounds.

High Variability in Silver Particle Characteristics, Silver Concentrations, and Production Batches of Commercially Available Products Indicates the Need for a More Rigorous Approach

Due to the beneficial properties of silver, it is anticipated that the number of commercially available applications will keep growing during the next decade. In this study, 14 different commercial products that claim to contain solid silver were characterized by visual analysis, UV-VIS spectroscopy, inductive coupled plasma optical emission spectrometry (ICP-OES), scanning transmission electron microscopy with energy dispersive x-ray spectroscopy (STEM-EDX), and dynamic light scattering (DLS). Moreover the variation between production batches-which has never been researched before-was investigated. All four techniques corroborated that some products were highly concentrated and contained spherically-shaped silver nanoparticles (AgNPs), while in others, no (solid) silver was detected or only irregularly-shaped silver particles with a high size polydispersity were present. For almost all products, a significant difference between the claimed and measured silver concentration was detected and a high variability between different production batches of the same product was observed. Our results show the need for a more rigorous approach regarding the manufacturing, labeling, and use of silver-containing products.

In vivo study of silver nanomaterials' toxicity with respect to size

Silver nanoparticles (Ag NPs) are widely used in nanomedicine, pharmaceutical products, industry and other consumer products owing to their unique physiochemical properties with probable potential risk to human health and the ecosystems. The aim of this work was to investigate the in-life morphological effects, biochemical, histological and histochemical alterations that might be induced by variable sizes of Ag NPs in hepatic, renal and testicular tissues with the hypothesis that variable sizes of nano-Ag could induce variable effects in the vital organs. Five groups of adult healthy male mice (BALB/C) were exposed to 35 intraperitoneal injections of Ag NPs (1 mg/kg bw) using five different particle sizes (10, 20, 40, 60 and 100 nm). All mice were subjected to in-life morphometric, biochemical, histological and histochemical analysis. The findings demonstrated that Ag NPs could induce alterations in the average body weight gain, food consumption, water intake and organ indices. In addition, these NPs significantly altered hepatic and renal biomarkers. Moreover, Ag NPs produced ground glass hepatocyte cytoplasm, with mitotic activity, nuclear alterations, degeneration, glycogen depletion and inflammatory cells infiltration in the liver. The kidneys of treated mice exhibited proximal renal tubules degeneration, distal renal tubules regeneration, glomerular shrinkage, Bowman's capsule thickening and interstitial inflammation. The testicular tissues demonstrated spermatocyte sloughing and spermatid giant cell formation. The findings together indicated that Ag NPs could interact with the anatomical structures of the liver, kidney and testis in ways that could induce injury. In addition, the results indicated that smaller Ag NPs posed a greater potential risk than the larger ones, which might be associated with their behaviour, dissolution rate, bioavailability and their probable variable toxicokinetics.

The Toxicity Phenomenon and the Related Occurrence in Metal and Metal Oxide Nanoparticles: A Brief Review From the Biomedical Perspective

Thousands of different nanoparticles (NPs) involve in our daily life with various origins from food, cosmetics, drugs, etc. It is believed that decreasing the size of materials up to nanometer levels can facilitate their unfavorable absorption since they can pass the natural barriers of live tissues and organs even, they can go across the relatively impermeable membranes. The interaction of these NPs with the biological environment disturbs the natural functions of cells and its components and cause health issues. In the lack of the detailed and comprehensive standard protocols about the toxicity of NPs materials, their control, and effects, this review study focuses on the current research literature about the related factors in toxicity of NPs such as size, concentration, etc. with an emphasis on metal and metal oxide nanoparticles. The goal of the study is to highlight their potential hazard and the advancement of green non-cytotoxic nanomaterials with safe threshold dose levels to resolve the toxicity issues. This study supports the NPs design along with minimizing the adverse effects of nanoparticles especially those used in biological treatments.

Treatment of chronic wounds with polyurethane sponges impregnated with boric acid particles: A randomised controlled trial

The objective of this study was to investigate the effectiveness of the sponge with boric acid particles combined with the negative pressure wound treatment (NPWT) system for chronic wounds with tissue defects. Our study was designed as a prospective randomised study. One hundred patients who were planned to have NPWT due to chronic wounds were included in this study from Orthopaedics and Traumatology and Plastic Surgery clinics. Patients were divided into two groups. In the first group, a new method, boric acid impregnated sponge, combined with the NPWT system, was used, and in the second group, sponge with silver nitrate was used. Besides the wide-broad spectrum antibacterial properties of silver nitrate, the antimicrobial, angiogenetic, and epithelial effects of boric acid were aimed to investigate by macroscopically and histopathologically. Thirty-six patients in the silver nitrate group and 44 patients in the boric acid group completed the study. A decrease in wound size and granulation was observed in both groups. Macroscopically, a decrease in wound size reduction, epithelialization and granulation were more prominent in the first group in which boric acid impregnated sponge was used than the second group in which silver sponge was used. Moreover, microscopically, the number of fibroblasts, collagen synthesis, and angiogenesis were significantly increased in Group 1. In this clinical study, the broad-spectrum antimicrobial properties of boric acid and its positive effect on the cells responsible for wound healing were found to be more pronounced compared to silver nitrate sponges. A combination of boric acid sponges with the NPWT system may be an alternative method for chronic wounds.

Wound, pressure ulcer and burn guidelines - 1: Guidelines for wounds in general, second edition

The Japanese Dermatological Association prepared the clinical guidelines for the "Wound, pressure ulcer and burn guidelines", second edition, focusing on treatments. Among them, "Guidelines for wounds in general" is intended to provide the knowledge necessary to heal wounds, without focusing on particular disorders. It informs the basic principles of wound treatment, before explanations are provided in individual chapters of the guidelines. We updated all sections by collecting references published since the publication of the first edition. In particular, we included new wound dressings and topical medications. Additionally, we added "Question 6: How should wound-related pain be considered, and what should be done to control it?" as a new section addressing wound pain, which was not included in the first edition.

Graphene Oxide Nanosheets for Localized Hyperthermia-Physicochemical Characterization, Biocompatibility, and Induction of Tumor Cell Death

Background: The main goals of cancer treatment are not only to eradicate the tumor itself but also to elicit a specific immune response that overcomes the resistance of tumor cells against chemo- and radiotherapies. Hyperthermia was demonstrated to chemo- and radio-sensitize cancerous cells. Many reports have confirmed the immunostimulatory effect of such multi-modal routines. Methods: We evaluated the interaction of graphene oxide (GO) nanosheets; its derivatives reduced GO and PEGylated rGO, with components of peripheral blood and evaluated its thermal conductivity to induce cell death by localized hyperthermia. Results: We confirmed the sterility and biocompatibility of the graphene nanomaterials and demonstrated that hyperthermia applied alone or in the combination with radiotherapy induced much more cell death in tumor cells than irradiation alone. Cell death was confirmed by the release of lactate dehydrogenase from dead and dying tumor cells. Conclusion: Biocompatible GO and its derivatives can be successfully used in graphene-induced hyperthermia to elicit tumor cell death.