Nicole Natarelli, BA 1 , Yvonne Nong, MS 2,3,4 , Jessica Maloh, ND 2,3 , Raja Sivamani, MD, MS, AP 2,3,5,6 a
1 Morsani College of Medicine, University of South Florida, Tampa, Florida, 2 Pacific Skin Institute, Sacramento, CA, 3 Zen Dermatology, Sacramento,
CA, 4 Michigan State University College of Human Medicine, Flint, Michigan, 5 Department of Dermatology, University of California-Davis, Sacramento,
CA , 6 College of Medicine, California Northstate University, Elk Grove, CA
Keywords: hypochlorous acid, integrative dermatology, wound healing, scar management, infection, atopic dermatitis, pruritus
Relevance
Hypochlorous acid (HClO) is a weak acid and powerful oxidant traditionally used as an active ingredient in various sanitizers and disinfectants. HClO is produced endogenously from activated leukocytes, and it was first exogenously synthesized in 1834, later to be used medicinally as a wound disinfectant during World War I and II.
Objective
In this review, we aim to review the literature assessing the efficacy and safety of dermatologic uses of topical hypochlorous acid.
Methods
A PubMed search for articles with the following keywords was performed: “hypochlorous acid” AND “dermatology” OR “dermis” OR “dermal.” Forty-one reports were included in the efficacy and safety analysis.
Results
Hypochlorous acid exhibits antimicrobial properties and has been demonstrated to promote re-epithelialization in wound healing with low cytotoxicity to keratinocytes and fibroblasts. Recent work has highlighted its anti-inflammatory properties via modulation of the NF-kβ signaling pathway and downregulation of inflammatory cytokines; reports have discussed its application for the management of various inflammatory skin conditions including atopic dermatitis and psoriasis.
Conclusion
Dermatologic application of hypochlorous acid includes infection prevention, wound care and scar management, inflammatory modulation, treatment in atopic dermatitis and pruritus. Emerging research has discussed potential applications in acne vulgaris, seborrheic dermatitis, and tumor suppression.
Le´o-Paul Tricou,1–3 Marie-Lynn Al-Hawat,1 Katia Cherifi,1 Gabriela Manrique,1 Benjamin R. Freedman,4,* and Simon Matoori1,*
1Faculte´ de Pharmacie, Universite´ de Montre´al, Montre´al, Canada.
2ISPB Faculte´ de Pharmacie, Universite´ Claude Bernard Lyon 1, Lyon, France.
3Chemical Engineering Department, Polytechnique Montreal, Montre´al, Canada.
4Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Massachusetts, USA.
Significance: Chronic diabetic wounds on the lower extremities (diabetic foot ulcers, DFU) are one of the most prevalent and life-threatening complications of diabetes, responsible for significant loss of quality of life and cost to the health care system. Available pharmacologic treatments fail to achieve com plete healing in many patients. Recent studies and investigational treatments have highlighted the potential of modulating wound pH in DFU.
Recent Advances: Data from in vitro, preclinical, and clinical studies highlight the role of pH in the pathophysiology of DFU, and topical administration of pH-lowering agents have shown promise as a therapeutic strategy for diabetic wounds. In this critical review, we describe the role of pH in DFU patho-physiology and present selected low-molecular-weight and hydrogel-based pH-modulating systems for wound healing and infection control in diabetic.
Critical Issues: The molecular mechanisms leading to pH alterations in diabetic wounds are complex and may differ between in vitro models, animal models of diabetes, and the human pathophysiology. Wound pH-lowering bandages for DFU therapy must be tested in established animal models of diabetic wound healing and patients with diabetes to establish a comprehensive benefit-risk profile.
Future Directions: As our understanding of the role of pH in the pathophysiology of diabetic wounds is deepening, new treatments for this therapeutic target are being developed and will be tested in preclinical and clinical studies. These therapeutic systems will establish a target product profile for pH-lowering treatments such as an optimal pH profile for each wound healing stage. Thus, controlling wound bed pH could become a powerful tool to accelerate chronic diabetic wound healing.
Keywords: pH management, diabetic wound healing, diabetes, pH-lowering strategies, pH modulation, acidic wound dressings
This article is excerpted from the 《Frontiers in Oncology》 by Wound World
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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