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Schrøder B, Tentor F, Miclăuş T, Stærk K, Andersen TE, Spinelli M, Rendeli C, Del Popolo G, Bagi P, Nielsen LF. New micro-hole zone catheter reduces residual urine and mucosal microtrauma in a lower urinary tract model. Sci Rep 2024; 14:2268. [PMID: 38280939 PMCID: PMC10821950 DOI: 10.1038/s41598-024-52505-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/19/2024] [Indexed: 01/29/2024] Open
Abstract
Urinary tract infections (UTIs) are the main complication associated with clean intermittent catheterization (CIC) and are facilitated by post-void residual urine and trauma to the mucosa during voiding. The risk of UTI may be diminished by reducing the residual volumes and preventing microtrauma caused by mucosal suction through the eyelets of conventional eyelet catheters (CEC). A new micro-hole zone catheter (MHZC) was developed and tested in an ex vivo porcine lower urinary tract model and in vivo, in pigs, against a CEC. It was shown that, irrespective of the micro-hole diameter, the new catheter ensured increased flowrates and significantly lower residual volumes at the first flow-stop. Furthermore, with a micro-hole diameter of 0.4 mm, mucosal suction was virtually eliminated, regardless of the insertion depth or simulated intra-abdominal pressure mimicking sitting or standing humans. Pressure profile experiments and endoscopy studies indicated that the bladder gradually folds against the drainage tip of the new catheter, without blocking the flow, and, unlike with the CEC, sharp pressure variations and flow-stops did not occur during voiding. The MHZC outperformed the CEC in all tested scenarios and decreased residual volumes, thus potentially decreasing the risk of UTIs.
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Affiliation(s)
| | - Fabio Tentor
- Coloplast A/S, Holtedam 1, 3050, Humlebaek, Denmark
| | | | - Kristian Stærk
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | | | - Claudia Rendeli
- Department of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulio Del Popolo
- Neuro-Urology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Per Bagi
- Department of Urology, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Landauro MH, Tentor F, Pedersen T, Jacobsen L, Bagi P. Improved Performance With the Micro-Hole Zone Intermittent Catheter: A Combined Analysis of 3 Randomized Controlled Studies Comparing the New Catheter Technology With a Conventional Eyelet Catheter. J Wound Ostomy Continence Nurs 2023; 50:504-511. [PMID: 37966080 PMCID: PMC10681284 DOI: 10.1097/won.0000000000001029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
PURPOSE To assess the performance of a new urinary intermittent catheter (IC) prototype designed with a micro-hole drainage zone compared to a conventional eyelet catheter (CEC) in terms of flow-stop, bladder emptying, and hematuria. DESIGN Randomized controlled crossover studies. SUBJECT AND SETTING The sample comprised 15 male healthy volunteers (HV) and 15 IC users, along with 15 female HV and 15 IC users. The age range was lower for HV participants than for IC users (range: 20-57 years for HV vs 21-82 years for IC users). The study setting was the Department of Urology, located in Rigshospitalet, Copenhagen. METHODS Number of flow-stop incidents, residual urine volume at first flow-stop (RV1), and dipstick hematuria were measured during and after catheterization by a health care professional (HV) and by self-catheterisation (IC-users). Results from the 3 studies were combined for HV and IC users on RV1 and number of flow-stop incidents but separated on sex. For incidents of hematuria, an effect of underlying condition was assumed, and a combined analysis on sex was performed, separating HV and IC users. RESULTS When compared to the micro-hole drainage zone design, catheterizations with CEC resulted in a significantly higher mean RV1 (mean difference: 49 mL in males and 32 mL in females, both P < .001) and average number of flow-stop incidents (8 and 21 times more frequent for males and females, respectively, both P < .001). The likelihood for hematuria was 5.84 higher with CEC than with micro-hole drainage hole design, P = .053, during normal micturition in HV postcatheterization. No serious adverse events were reported. CONCLUSION The micro-hole drainage zone catheter provides IC users fewer premature flow-stops. This design feature reduces modifiable urinary tract infection risk factors, such as residual urine and micro-trauma; additional research is needed to determine its effects on bladder health.
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Affiliation(s)
- Malene Hornbak Landauro
- Correspondence: Malene Hornbak Landauro, PhD, Coloplast A/S, Holtedam 3, 3050 Humlebaek, Denmark ()
| | - Fabio Tentor
- Malene Hornbak Landauro, PhD, Coloplast A/S, Humlebæk, Denmark
- Fabio Tentor, PhD, Coloplast A/S, Humlebæk, Denmark
- Troels Pedersen, MS, Coloplast A/S, Humlebæk, Denmark
- Lotte Jacobsen, MS, Coloplast A/S, Humlebæk, Denmark
- Per Bagi, MD, Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Troels Pedersen
- Malene Hornbak Landauro, PhD, Coloplast A/S, Humlebæk, Denmark
- Fabio Tentor, PhD, Coloplast A/S, Humlebæk, Denmark
- Troels Pedersen, MS, Coloplast A/S, Humlebæk, Denmark
- Lotte Jacobsen, MS, Coloplast A/S, Humlebæk, Denmark
- Per Bagi, MD, Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lotte Jacobsen
- Malene Hornbak Landauro, PhD, Coloplast A/S, Humlebæk, Denmark
- Fabio Tentor, PhD, Coloplast A/S, Humlebæk, Denmark
- Troels Pedersen, MS, Coloplast A/S, Humlebæk, Denmark
- Lotte Jacobsen, MS, Coloplast A/S, Humlebæk, Denmark
- Per Bagi, MD, Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Per Bagi
- Malene Hornbak Landauro, PhD, Coloplast A/S, Humlebæk, Denmark
- Fabio Tentor, PhD, Coloplast A/S, Humlebæk, Denmark
- Troels Pedersen, MS, Coloplast A/S, Humlebæk, Denmark
- Lotte Jacobsen, MS, Coloplast A/S, Humlebæk, Denmark
- Per Bagi, MD, Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Landauro MH, Jacobsen L, Tentor F, Pedersen T, Rovsing C, Feix do Nascimento O, Kennelly M. New Intermittent Urinary Micro-Hole Zone Catheter Shows Enhanced Performance in Emptying the Bladder: A Randomised, Controlled Crossover Study. J Clin Med 2023; 12:5266. [PMID: 37629309 PMCID: PMC10455232 DOI: 10.3390/jcm12165266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/13/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Urinary tract infections (UTIs) are common and troublesome complications of clean intermittent catheterisation (CIC) in individuals suffering from incomplete bladder emptying, which may exacerbate the underlying disease and lead to hospitalisation. Aside from the design of the intermittent catheter and its handling, a recent review highlighted residual urine as one of several UTI risk factors. A new urinary intermittent catheter with multiple micro-holes has been developed for improved bladder emptying. In a controlled crossover study, adult male CIC users were randomised for a health care professional-led catheterisation with the new micro-hole zone catheter (MHZC) and a conventional eyelet catheter (CEC) in two individual test visits to compare the number of flow-stops and the residual urine at the first flow-stop as co-primary endpoints. In 42 male CIC users, the MHZC resulted in significantly fewer flow-stop episodes compared to the CEC (mean 0.17, 95% CI [0.06, 0.45] vs. mean 1.09, 95% CI [0.75, 1.6], respectively; p < 0.001) and significantly less residual urine at the first flow-stop (mean 5.10 mL, SE [1.14] vs. mean 39.40 mL, SE [9.65], respectively; p < 0.001). No adverse events were observed in this study. The results confirm the enhanced performance of the MHZC compared to a CEC, ensuring an uninterrupted free urine flow with no need to reposition the catheter until the bladder is thoroughly empty.
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Affiliation(s)
| | - Lotte Jacobsen
- Coloplast A/S, 3050 Humlebæk, Denmark; (L.J.); (F.T.); (T.P.); (O.F.d.N.)
| | - Fabio Tentor
- Coloplast A/S, 3050 Humlebæk, Denmark; (L.J.); (F.T.); (T.P.); (O.F.d.N.)
| | - Troels Pedersen
- Coloplast A/S, 3050 Humlebæk, Denmark; (L.J.); (F.T.); (T.P.); (O.F.d.N.)
| | | | | | - Michael Kennelly
- Department of Urology, Carolinas Medical Center, Charlotte, NC 28207, USA;
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Tentor F, Grønholt Schrøder B, Nielsen S, Schertiger L, Stærk K, Emil Andersen T, Bagi P, Feldskov Nielsen L. Author Correction: Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters. Sci Rep 2023; 13:6443. [PMID: 37081107 PMCID: PMC10119277 DOI: 10.1038/s41598-023-32920-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Affiliation(s)
- Fabio Tentor
- Coloplast A/S, Holtedam 1, 3050, Humlebæk, Denmark.
| | | | | | | | - Kristian Stærk
- Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000, Odense, Denmark
- Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000, Odense, Denmark
| | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000, Odense, Denmark
- Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000, Odense, Denmark
| | - Per Bagi
- Department of Urology, Centre for Cancer and Organ Diseases, Rigshospitalet, Blegdamsvej 9, 2100, København, Denmark
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Tentor F, Grønholt Schrøder B, Nielsen S, Schertiger L, Stærk K, Emil Andersen T, Bagi P, Feldskov Nielsen L. Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters. Sci Rep 2022; 12:17818. [PMID: 36280778 PMCID: PMC9592621 DOI: 10.1038/s41598-022-21122-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/22/2022] [Indexed: 01/19/2023] Open
Abstract
Intermittent catheterization is the gold standard method for bladder management in individuals with urinary retention and/or incontinence. It is therefore important to understand the performance of urinary catheters, especially on parameters associated to risks of developing urinary tract infections, and that may impact the quality of life for urinary catheter users. Examples of such parameters include, urine flowrate, occurrence of flow-stops, and residual urine left in the bladder after flow-stop. Reliable in-vitro and/or ex-vivo laboratory models represent a strong asset to assess the performance of urinary catheters, preceding and guiding in-vivo animal studies and/or human clinical studies. Existing laboratory models are generally simplified, covering only portions of the catheterization process, or poorly reflect clinical procedures. In this work, we developed an ex-vivo porcine lower urinary tract model that better reflects the catheterization procedure in humans and allows to investigate the performance of standard of care catheters. The performance of three standard of care catheters was investigated in the developed model showing significant differences in terms of flowrate. No differences were detected in terms of residual volume in the bladder at first flow-stop also when tuning the abdominal pressure to mimic a sitting down and standing up position. A newly discovered phenomenon named hammering was detected and measured. Lastly, mucosal suction was observed and measured in all standard of care catheters, raising the concern for microtrauma during catheterization and a need for new and improved urinary catheter designs. Results obtained with the ex-vivo model were compared to in-vivo studies, highlighting similar concerns.
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Affiliation(s)
- Fabio Tentor
- grid.424097.c0000 0004 1755 4974Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark
| | | | - Simon Nielsen
- grid.424097.c0000 0004 1755 4974Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark
| | - Lars Schertiger
- grid.424097.c0000 0004 1755 4974Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark
| | - Kristian Stærk
- grid.10825.3e0000 0001 0728 0170Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000 Odense, Denmark ,grid.7143.10000 0004 0512 5013Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000 Odense, Denmark
| | - Thomas Emil Andersen
- grid.10825.3e0000 0001 0728 0170Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000 Odense, Denmark ,grid.7143.10000 0004 0512 5013Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000 Odense, Denmark
| | - Per Bagi
- grid.475435.4Department of Urology, Centre for Cancer and Organ Diseases, Rigshospitalet, Blegdamsvej 9, 2100 København, Denmark
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Tentor F, Siccardi G, Sacco P, Demarchi D, Marsich E, Almdal K, Bose Goswami S, Boisen A. Long lasting mucoadhesive membrane based on alginate and chitosan for intravaginal drug delivery. J Mater Sci Mater Med 2020; 31:25. [PMID: 32060634 DOI: 10.1007/s10856-020-6359-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/07/2020] [Indexed: 05/23/2023]
Abstract
The intravaginal route of administration can be exploited to treat local diseases and for systemic delivery. In this work, we developed an alginate/chitosan membrane sufficiently stable in a simulated vaginal fluid and able to dissolve over time at a very slow and linear rate. The membrane demonstrated good mechanical properties both in its swollen and dry form. As a study case, we evaluated the viability of this potential drug delivery system for the treatment of bacterial vaginosis, a common disease affecting women in their reproductive age. Metronidazole was effectively included in the alginate/chitosan membrane and its bactericide effect was demonstrated against Staphylococcus aureus and Gardnerella vaginalis, simultaneously showing good biocompatibility with a cervix epithelial cell line. Since this alginate/chitosan membrane is stable in a simulated vaginal environment, is easy to fabricate and can be used for the controlled release of a model drug, it represents a promising drug delivery system for local intravaginal applications.
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Affiliation(s)
- Fabio Tentor
- Department of Health Technology, Technical University of Denmark, Ørsteds Plads 345C, 2800 Kgs., Lyngby, Denmark.
| | - Giorgia Siccardi
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129, Torino, Italy
| | - Pasquale Sacco
- Department of Life Sciences, University of Trieste, via L. Giorgieri 5, I-34127, Trieste, Italy
| | - Danilo Demarchi
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129, Torino, Italy
| | - Eleonora Marsich
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, I-34129, Trieste, Italy
| | - Kristoffer Almdal
- Department of Chemistry, Technical University of Denmark, Kemitorvet 207, 2800 Kgs., Lyngby, Denmark
| | - Sanjukta Bose Goswami
- Department of Health Technology, Technical University of Denmark, Ørsteds Plads 345C, 2800 Kgs., Lyngby, Denmark
| | - Anja Boisen
- Department of Health Technology, Technical University of Denmark, Ørsteds Plads 345C, 2800 Kgs., Lyngby, Denmark
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Mazzoni C, Tentor F, Antalaki A, Jacobsen RD, Mortensen J, Slipets R, Ilchenko O, Keller SS, Nielsen LH, Boisen A. Where Is the Drug? Quantitative 3D Distribution Analyses of Confined Drug-Loaded Polymer Matrices. ACS Biomater Sci Eng 2019; 5:2935-2941. [DOI: 10.1021/acsbiomaterials.9b00495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Chiara Mazzoni
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Fabio Tentor
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Anastasia Antalaki
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Rasmus D. Jacobsen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Jacob Mortensen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Roman Slipets
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Oleksii Ilchenko
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Stephan S. Keller
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), National Centre for Nano Fabrication and Characterization, Technical University of Denmark, Ørsteds Plads Building 345B, Kgs. Lyngby 2800, Denmark
| | - L. Hagner Nielsen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
| | - Anja Boisen
- The Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsteds Plads Building 345C, Kgs. Lyngby 2800, Denmark
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Mazzoni C, Tentor F, Strindberg SA, Nielsen LH, Keller SS, Alstrøm TS, Gundlach C, Müllertz A, Marizza P, Boisen A. From concept to in vivo testing: Microcontainers for oral drug delivery. J Control Release 2017; 268:343-351. [DOI: 10.1016/j.jconrel.2017.10.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/11/2017] [Accepted: 10/12/2017] [Indexed: 11/16/2022]
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Sacco P, Decleva E, Tentor F, Menegazzi R, Borgogna M, Paoletti S, Kristiansen KA, Vårum KM, Marsich E. Butyrate-Loaded Chitosan/Hyaluronan Nanoparticles: A Suitable Tool for Sustained Inhibition of ROS Release by Activated Neutrophils. Macromol Biosci 2017; 17. [PMID: 28869330 DOI: 10.1002/mabi.201700214] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/31/2017] [Indexed: 12/26/2022]
Abstract
Tissue damage caused by excessive amounts of neutrophil-derived reactive oxygen species (ROS) occurs in many inflammatory diseases. Butyrate is a short-chain fatty acid (SCFA) with known anti-inflammatory properties, able to modulate several neutrophil functions. Evidence is provided here that butyrate inhibits neutrophil ROS release in a dose and time-dependent fashion. Given the short half-life of butyrate, chitosan/hyaluronan nanoparticles are next designed and developed as controlled release carriers able to provide cells with a long-lasting supply of this SCFA. Notably, while the inhibition of neutrophil ROS production by free butyrate declines over time, that of butyrate-loaded chitosan/hyaluronan nanoparticles (B-NPs) is sustained. Additional valuable features of these nanoparticles are inherent ROS scavenger activity, resistance to cell internalization, and mucoadhesiveness. B-NPs appear as promising tools to limit ROS-dependent tissue injury during inflammation. Particularly, by virtue of their mucoadhesiveness, B-NPs administered by enema can be effective in the treatment of inflammatory bowel diseases.
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Affiliation(s)
- Pasquale Sacco
- Department of Life Sciences, University of Trieste, Via L. Giorgieri 5, I-34127, Trieste, Italy
| | - Eva Decleva
- Department of Life Sciences, University of Trieste, Via L. Giorgieri 5, I-34127, Trieste, Italy
| | - Fabio Tentor
- Department of Life Sciences, University of Trieste, Via L. Giorgieri 5, I-34127, Trieste, Italy.,Department of Micro- and Nanotechnology, Technical University of Denmark, Building 345C, 2800, Kgs. Lyngby, Denmark
| | - Renzo Menegazzi
- Department of Life Sciences, University of Trieste, Via L. Giorgieri 5, I-34127, Trieste, Italy
| | - Massimiliano Borgogna
- Department of Life Sciences, University of Trieste, Via L. Giorgieri 5, I-34127, Trieste, Italy
| | - Sergio Paoletti
- Department of Life Sciences, University of Trieste, Via L. Giorgieri 5, I-34127, Trieste, Italy
| | - Kåre Andre Kristiansen
- Norwegian Biopolymer Laboratory (NOBIPOL), Department of Biotechnology, Norwegian University of Science and Technology (NTNU), NO-7491, Trondheim, Norway
| | - Kjell Morten Vårum
- Norwegian Biopolymer Laboratory (NOBIPOL), Department of Biotechnology, Norwegian University of Science and Technology (NTNU), NO-7491, Trondheim, Norway
| | - Eleonora Marsich
- Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, I-34129, Trieste, Italy
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