title: A New Acid-oxidizing Solution: Assessment of Its Role on Methicillin-resistant Staphylococcus aureus (MRSA) Biofilm Morphological Changes.
abstract: OBJECTIVE
  Biofilms represent a key challenge in the treatment of chronic wounds, as they are among the main reasons for delays in chronic wound healing. This in vitro study was aimed at evaluating the activity of a new acid-oxidizing solution (AOS) on biofilm formation. Acid-oxidizing solution contains free chlorine species with stabilized hypochlorous acid in high concentration (> 95%) and is characterized by acidic (pH less than 3) and super-oxidizing (Redox greater than 1000mV) features.
  
  
  METHODS
  A 3-dimensional in vitro model of reconstructed human epidermis was used to compare the activity of AOS vs 2 reference products (RP) containing betaine and polyhexanide (RP1) and sodium hypochlorite and hypochlorous acid (RP2). Different approaches were used to assess the prevention and eradication of methicillin-resistant Staphyloccocus aureus biofilm by the study products. Xylitol and chlorhexidine were used as positive controls. The activity of the study products on the biofilm structure was evaluated analyzing the ultrastructural modification by scanning electron microscopy, while skin compatibility was assessed on noncolonized tissues measuring the metabolic activity of the cells.
  
  
  RESULTS
  In all experiments, AOS showed to be active on the biofilm matrix, modifying its structure and allowing bacterial release from the matrix. In all experiments, no cytotoxicity was observed in the tissues treated with the product suggesting a good compatibility of AOS with skin tissues. Reference product 1 affected the biofilm, suggesting a disruption effect; RP2 was slightly less active than AOS in modifying the biofilm structure.
  
  
  CONCLUSIONS
  Treatment with AOS affects biofilm by modifying its structure and therefore facilitating local bacteria accessibility to bactericidal agents, with consequent potential clinical benefits in the treatment of chronic wounds.
authors.affiliation: Angelini Research S.p.A.,Santa Polumba, Rome, Italy.
authors.forename: Noemi
authors.initials: N
authors.lastname: D'Atanasio
authors.affiliation: Angelini Research S.p.A.,Santa Polumba, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Capezzone de Joannon
authors.affiliation: Angelini Research S.p.A.,Santa Polumba, Rome, Italy.
authors.forename: Giorgina
authors.initials: G
authors.lastname: Mangano
authors.affiliation: VitroScreen Srl, Milan, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: Meloni
authors.affiliation: APR Applied Pharma Research S.A., Balerna, Switzerland.
authors.forename: Nadia
authors.initials: N
authors.lastname: Giarratana
authors.affiliation: Angelini Research S.p.A.,Santa Polumba, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Milanese
authors.affiliation: Angelini Research S.p.A.,Santa Polumba, Rome, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Tongiani
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D006801:Humans; D066298:In Vitro Techniques; D008712:Methicillin / Q000494:pharmacology*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008855:Microscopy, Electron, Scanning; D019999:Pharmaceutical Solutions / Q000494:pharmacology*; D012973:Sodium Hypochlorite / Q000494:pharmacology*; D014945:Wound Healing / Q000187:drug effects; D014946:Wound Infection / Q000382:microbiology* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D019999:Pharmaceutical Solutions; D012973:Sodium Hypochlorite; D008712:Methicillin