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Arnitz R, Stein M, Bauer P, Lanthaler B, Jamnig H, Scholl-Bürgi S, Stempfl-Al-Jazrawi K, Ulmer H, Baumgartner B, Embacher S, Geisler S, Gostner JM, Müllinger B, Kälz B, Nagl M. Tolerability of inhaled N-chlorotaurine in humans: a double-blind randomized phase I clinical study. Ther Adv Respir Dis 2019; 12:1753466618778955. [PMID: 29857780 PMCID: PMC5985600 DOI: 10.1177/1753466618778955] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND N-chlorotaurine (NCT), a long-lived oxidant produced by human leukocytes, can be synthesized chemically and used topically as a well-tolerated antiseptic to different body regions including sensitive ones. The aim of this study was to test the tolerability of inhaled 1% NCT in aqueous solution upon repeated application. METHODS The study was performed double-blind and randomized with a parallel test group (1% NCT) and control group (0.9% NaCl as placebo). There were two Austrian centres involved, the hospitals, Natters and Vöcklabruck. Healthy, full age volunteers were included, 12 in each centre. A total of 12 patients were treated with NCT, and 12 with placebo, exactly half of each group from each centre. The single dose was 1.2 ml inhaled over a period of 10 min using an AKITA JET nebulizer. One inhalation was done every day for five consecutive days. The primary criterion of evaluation was the forced expiratory volume in 1 second (FEV1). Secondary criteria were subjective sensations, further lung function parameters such as airway resistance, physical examination, and blood analyses (gases, electrolytes, organ function values, pharmacokinetic parameters taurine and methionine, immune parameters). RESULTS All included 15 females and 9 males completed the treatment and the control examinations according to the study protocol. FEV1 (100.83% ± 8.04% for NCT and 92.92% ± 11.35% for controls) remained unchanged and constant during the treatment and in control examinations 1 week and 3 months after the treatment (98.75% ± 7.37% for NCT and 91.17% ± 9.46% for controls, p > 0.082 between time points within each group). The same was true for all other objective parameters. Subjective mild sensations with a higher frequency in the test group were chlorine taste ( p < 0.01) and occasional tickle in the throat ( p = 0.057). Taurine and methionine plasma concentrations did not change within 60 min after inhalation or later on. CONCLUSIONS Inhaled NCT is well tolerated as in other applications of different body regions. Side effects are mild, topical and transitory. The study was registered prospectively in the European Clinical Trials Database of the European Medicines Agency. The EudraCT number is 2012-003700-12.
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Affiliation(s)
- Roland Arnitz
- District Hospital Vöcklabruck, Department of Pneumology, Vöcklabruck, Austria
| | - Markus Stein
- Public Hospital Natters, Department of Pneumology, Natters, Austria
| | - Petra Bauer
- Public Hospital Natters, Department of Pneumology, Natters, Austria
| | - Barbara Lanthaler
- Clinical Trial Center, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Jamnig
- Public Hospital Natters, Department of Pneumology, Natters, Austria
| | - Sabine Scholl-Bürgi
- Department of Pediatrics I (Inherited Metabolic Disorders), Medical University of Innsbruck, Innsbruck, Austria
| | | | - Hanno Ulmer
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Austria
| | | | - Sabine Embacher
- Clinical Trial Center, Medical University of Innsbruck, Innsbruck, Austria
| | - Simon Geisler
- Division of Medical Biochemistry, Medical University of Innsbruck, Innsbruck, Austria
| | - Johanna M Gostner
- Division of Medical Biochemistry, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Beate Kälz
- Sanochemia Pharmazeutika AG, Neufeld, Austria
| | - Markus Nagl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstr. 41, Innsbruck A-6020, Austria
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Bellmann-Weiler R, Maass V, Arnitz R, Weiss G, Maass M, Nagl M. The endogenous antiseptic N-chlorotaurine irreversibly inactivates Chlamydia pneumoniae and Chlamydia trachomatis. J Med Microbiol 2018; 67:1410-1415. [PMID: 30074473 DOI: 10.1099/jmm.0.000815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
PURPOSE The antimicrobial activity of N-chlorotaurine (NCT), an endogenous long-lived oxidant applied topically, was tested against Chlamydiae in vitro. METHODOLOGY Elementary bodies of Chlamydia pneumoniae strain CV-6 and Chlamydia trachomatis serovars A and D were incubated in 0.01, 0.1 and 1 % (w/v) NCT solution at pH 7.1 and 37 °C. After different incubation times, aliquots were removed and grown in cell culture. The number of inclusion forming units was quantified by immunofluorescence and real-time qPCR.Results/Key findings.Chlamydia pneumoniae and Chlamydia trachomatis were inactivated by 1 and 0.1 % NCT within 1 min. Moreover, 0.025-0.1 % NCT significantly reduced the number of intracellularly growing C. pneumoniae within 30 min. CONCLUSIONS This is the first study demonstrating the antimicrobial activity of NCT against Chlamydiae. Clinical implications of these findings have to be investigated in further trials.
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Affiliation(s)
- Rosa Bellmann-Weiler
- 1Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, Anichstr. 35, A-6020 Innsbruck, Austria
| | - Viola Maass
- 2Labor Dr. Heidrich & Kollegen, Stuvkamp 22, D-22081 Hamburg, Germany
| | - Roland Arnitz
- 3Department of Pulmonary Diseases, Hospital Vöcklabruck, Dr. Wilhelm-Bock-Strasse 1, A-4840, Vöcklabruck, Austria
| | - Günter Weiss
- 1Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, Anichstr. 35, A-6020 Innsbruck, Austria
| | - Matthias Maass
- 2Labor Dr. Heidrich & Kollegen, Stuvkamp 22, D-22081 Hamburg, Germany
| | - Markus Nagl
- 4Department of Hygiene, Microbiology and Public Health, Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstr. 41, A-6020 Innsbruck, Austria
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Arnitz R, Nagl M, Gottardi W. Comparison of the Microbicidal activity of monochloramine and iodine. Lett Appl Microbiol 2015; 61:518-22. [DOI: 10.1111/lam.12490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 08/04/2015] [Accepted: 08/29/2015] [Indexed: 11/26/2022]
Affiliation(s)
- R. Arnitz
- District Hospital Vöcklabruck; Department of Pneumology; Vöcklabruck Austria
- Department of Hygiene; Microbiology and Social Medicine; Division of Hygiene and Medical Microbiology; Medical University of Innsbruck; Innsbruck Austria
| | - M. Nagl
- Department of Hygiene; Microbiology and Social Medicine; Division of Hygiene and Medical Microbiology; Medical University of Innsbruck; Innsbruck Austria
| | - W. Gottardi
- Department of Hygiene; Microbiology and Social Medicine; Division of Hygiene and Medical Microbiology; Medical University of Innsbruck; Innsbruck Austria
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Arnitz R, Nagl M, Gottardi W. Microbicidal activity of monochloramine and chloramine T compared. J Hosp Infect 2009; 73:164-70. [DOI: 10.1016/j.jhin.2009.06.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Accepted: 06/10/2009] [Indexed: 11/29/2022]
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Geiger R, Treml B, Pinna A, Barnickel L, Prossliner H, Reinstadler H, Pilch M, Hauer M, Walther C, Steiner HJ, Giese T, Wemhöner A, Scholl-Bürgi S, Gottardi W, Arnitz R, Sergi C, Nagl M, Löckinger A. Tolerability of inhaled N-chlorotaurine in the pig model. BMC Pulm Med 2009; 9:33. [PMID: 19602222 PMCID: PMC2722574 DOI: 10.1186/1471-2466-9-33] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 07/14/2009] [Indexed: 11/10/2022] Open
Abstract
Background N-chlorotaurine, a long-lived oxidant produced by human leukocytes, can be applied in human medicine as an endogenous antiseptic. Its antimicrobial activity can be enhanced by ammonium chloride. This study was designed to evaluate the tolerability of inhaled N-chlorotaurine (NCT) in the pig model. Methods Anesthetized pigs inhaled test solutions of 1% (55 mM) NCT (n = 7), 5% NCT (n = 6), or 1% NCT plus 1% ammonium chloride (NH4Cl) (n = 6), and 0.9% saline solution as a control (n = 7), respectively. Applications with 5 ml each were performed hourly within four hours. Lung function, haemodynamics, and pharmacokinetics were monitored. Bronchial lavage samples for captive bubble surfactometry and lung samples for histology and electron microscopy were removed. Results Arterial pressure of oxygen (PaO2) decreased significantly over the observation period of 4 hours in all animals. Compared to saline, 1% NCT + 1% NH4Cl led to significantly lower PaO2 values at the endpoint after 4 hours (62 ± 9.6 mmHg vs. 76 ± 9.2 mmHg, p = 0.014) with a corresponding increase in alveolo-arterial difference of oxygen partial pressure (AaDO2) (p = 0.004). Interestingly, AaDO2 was lowest with 1% NCT, even lower than with saline (p = 0.016). The increase of pulmonary artery pressure (PAP) over the observation period was smallest with 1% NCT without difference to controls (p = 0.91), and higher with 5% NCT (p = 0.02), and NCT + NH4Cl (p = 0.05). Histological and ultrastructural investigations revealed no differences between the test and control groups. The surfactant function remained intact. There was no systemic resorption of NCT detectable, and its local inactivation took place within 30 min. The concentration of NCT tolerated by A549 lung epithelial cells in vitro was similar to that known from other body cells (0.25–0.5 mM). Conclusion The endogenous antiseptic NCT was well tolerated at a concentration of 1% upon inhalation in the pig model. Addition of ammonium chloride in high concentration provokes a statistically significant impact on blood oxygenation.
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Affiliation(s)
- Ralf Geiger
- Department of Hygiene, Microbiology and Social Medicine, Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria.
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Neher A, Arnitz R, Gstöttner M, Schäfer D, Kröss EM, Nagl M. Antimicrobial activity of dexamethasone and its combination with N-chlorotaurine. ACTA ACUST UNITED AC 2008; 134:615-20. [PMID: 18559728 DOI: 10.1001/archotol.134.6.615] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To investigate the antimicrobial effect of dexamethasone phosphate, the endogenous antiseptic N-chlorotaurine (NCT), and their combination on ear, nose, and throat microorganisms. DESIGN In vitro study. SUBJECTS Strains of Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus milleri, Aspergillus flavus, and Aspergillus fumigatus. INTERVENTIONS Bacterial and fungal strains were cultured with 0.1% dexamethasone with and without a low (0.1%) or high (1%) concentration of NCT. The killing effects of dexamethasone, NCT, and the combination were monitored. RESULTS Dexamethasone killed S. milleri and A. flavus after incubation times of 24 to 48 hours. The low concentration of NCT caused a 90% reduction of S. aureus and P. aeruginosa within 30 minutes and 99.9% reduction within 50 minutes. The high concentration of NCT reduced viable counts of S. aureus and P. aeruginosa to the detection limit within 10 minutes. The low-concentration combination (0.1% dexamethasone and 0.1% NCT) showed significant (P < .01) synergistic killing of S. aureus with 2- to 3-fold shorter killing times. The high-concentration combination (0.1% dexamethasone and 1% NCT) demonstrated more rapid killing than NCT alone in both S. aureus and P. aeruginosa. CONCLUSIONS With short and intermediate exposure times, the combination of dexamethasone and NCT showed significantly stronger antimicrobial effects than treatment with NCT alone. Significant killing of S. milleri, A. flavus, and A. fumigatus was observed after extended exposure to dexamethasone. The combined application of dexamethasone and NCT might be a promising therapeutic option, producing high efficacy with low side effects.
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Affiliation(s)
- Andreas Neher
- Department of Otorhinolaryngology, Innsbruck Medical University, Anichstr 35, Innsbruck, Austria.
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Gottardi W, Arnitz R, Nagl M. N-Chlorotaurine and ammonium chloride: An antiseptic preparation with strong bactericidal activity. Int J Pharm 2007; 335:32-40. [PMID: 17196346 DOI: 10.1016/j.ijpharm.2006.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2006] [Accepted: 10/25/2006] [Indexed: 12/01/2022]
Abstract
The bactericidal activity of the endogenous antiseptic N-chlorotaurine (NCT) is significantly enhanced in the presence of ammonium chloride which induces the formation of monochloramine (NH(2)Cl) whose strong bactericidal activity is well known. In this study the properties of NCT plus ammonium chloride have been investigated. The reaction of active chlorine compounds like chloramine-T (N-chlorotoluene-sulfonamide sodium), chloroisocyanuric acid derivatives, hypochlorites (NaOCl, CaOCl(2)) with ammonium chloride did not stop at the stage of monochloramine, and the pungent smelling by-products di- and trichloramine, NHCl(2) and NCl(3), were also formed. This was not the case with NCT where only monochloramine was generated. The equilibrium constant of the reaction of NCT with ammonium was found to be [Formula: see text] , which allows to estimate the equilibrium concentration of monochloramine in aqueous solutions of NCT and ammonium chloride. At concentrations each ranging between 0.01% and 1.0% it comes to [NH(2)Cl]=3.5-254 ppm. As an unexpected result the monochloramine containing formulation turned out to be most stable in plain water without buffer additives. Quantitative killing assays revealed complete inactivation of 10(6) to 10(7)CFU/mL of seven bacterial strains by 0.1% NCT plus 0.1% ammonium chloride within 5 min, while with plain 0.1% NCT an incubation time of 2-4h was needed to achieve the same effect. The highly significant increase of bactericidal activity (200-300-fold) could be assigned to the presence of monochloramine which could be isolated by vacuum distillation. Aqueous solutions of NCT and ammonium chloride provide a highly effective and well tolerable antiseptic preparation appropriate to a treatment cycle of at least 1 month if stored in the refrigerator.
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Affiliation(s)
- Waldemar Gottardi
- Department of Hygiene, Microbiology and Social Medicine, Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria.
| | - Roland Arnitz
- Department of Hygiene, Microbiology and Social Medicine, Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria
| | - Markus Nagl
- Department of Hygiene, Microbiology and Social Medicine, Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria
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Abstract
N-Chlorotaurine sodium (NCT) is a promising microbicidal agent for topical treatment of infections. Its targets of attack in Escherichia coli have been investigated by proteomics. Incubation in 1% NCT for 10 and 30 min revealed a change of the charge and a separation of numerous proteins into a series of spots with a different pI. Charge differences could be related to oxidation of cysteine residues to their corresponding sulfonic acids. Heat shock protein 60 appeared, while ribosome-releasing factor, d-ribose periplasmic binding protein, and malonyl-CoA transacylase spots decreased. These results indicate penetration of oxidation capacity into the bacteria and destruction of essential proteins by NCT.
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Affiliation(s)
- Roland Arnitz
- Department of Hygiene, Microbiology and Social Medicine, Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria
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Arnitz R, Ott HW, Gstöttner M, Nagl M, Scholtz AW, Neher A. A novel N-chlorotaurine-corticosteroid combination as a preservative-free local disinfectant: influence on the ciliary beat frequency in vitro. Acta Otolaryngol 2006; 126:291-4. [PMID: 16618657 DOI: 10.1080/00016480500388935] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSIONS The combination of N-chlorotaurine (NCT) and a corticosteroid seems to be a very promising substance for the local therapy of ENT infections. As it can be used without any preservatives, the effect on the ciliary beat frequency (CBF) is much less than that of products containing benzalkonium chloride (BAC). The in vitro results obtained in this study encourage us to perform clinical trials on this novel combination for intranasal application. OBJECTIVE To investigate the influence of a novel mixture of NCT and a corticosteroid [fluticasone propionate (FP)] on the CBF of human ciliated cells in vitro. MATERIAL AND METHODS The study was designed as an in vitro study. CBF was measured by means of a photometric technique involving the combination of a light microscope, a photometer, a photographic multiplier and a computerized analyzing unit. RESULTS The combination of 1% NCT + 0.5 mg/ml FP decreased the CBF to 42.17% of its original value after 20 min. Treatment with BAC lowered the CBF depending on the concentration to 96.61% of its original value with 0.04 mg/ml, to 91.90% with 0.1 mg/ml, to 63.46% with 0.2 mg/ml and to 0% with 0.5 mg/ml. After rinsing in saline, the CBF of samples treated with 1% NCT + 0.5 mg/ml FP recovered to 68.93% of its original value.
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Affiliation(s)
- Roland Arnitz
- Department of Otorhinolaryngology, Innsbruck Medical University, Innsbruck, Austria
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