Electrolyzed hypochlorous acid water exhibits potent disinfectant activity against various viruses through irreversible protein aggregation

Rahmi Dianty^1,2 , Junki Hirano^1,2 , Itsuki Anzai^1,3 , Yuta Kanai^1,4 , Tsuyoshi Hayashi⁵ , Masae Morimoto⁶ , Chikako Kataoka-Nakamura⁶ , Sakura Kobayashi⁵ , Kentaro Uemura^1,2 , Chikako Ono^1,2 , Tokiko Watanabe^1,3,7 , Takeshi Kobayashi^1,4,7 , Kosuke Murakami⁵ , Kenji Kikuchi⁸ , Kunimoto Hotta⁸ , Toshikazu Yoshikawa⁸ , Shuhei Taguwa^{1,2,7 *} and Yoshiharu Matsuura^{1,2,7 *}

¹ Laboratory of Virus Control, Center for Infectious Disease Education and Research, Osaka University, Osaka, Japan, 2Laboratory of Virus Control, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan, 3Laboratory of Molecular Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan, 4Laboratory of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan, 5Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan, 6Innovative Vaccine Research and Development Center, The Research Foundation for Microbial Diseases of Osaka University, Osaka, Japan, 7 Center for Advanced Modalities and DDS, Osaka University, Osaka, Japan, 8Louis Pasteur Center for Medical Research, Kyoto, Japan

It is essential to employ efficient measures to prevent the transmission of pathogenic agents during a pandemic. One such method involves using hypochlorous acid (HClO) solution. The oxidative properties of HClO water (HAW) can contribute to its ability to eliminate viral particles. Here, we examined a highly purified slightly acidic hypochlorous acid water (Hp-SA-HAW) obtained from the reverse osmosis membrane treatment of an electrolytically-generated SA-HAW for its anti-viral activity and mode of action on viral proteins. Hp-SA-HAW exhibited broad-spectrum antiviral effects against various viruses, including adenovirus, hepatitis B virus, Japanese encephalitis virus (JEV), and rotavirus. Additionally, Hp-SA-HAW treatment dose-dependently resulted in irreversibly aggregated multimers of the JEV envelope and capsid proteins. However, Hp-SA-HAW treatment had no discernible effect on viral RNA, indicating that Hp-SA HAW acts against amino acids rather than nucleic acids. Furthermore, Hp-SA-HAW substantially reduced the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including the ancestral variant and other multiple variants. Hp-SA-HAW treatment induced the aggregation of the SARS-CoV-2 spike and nuclear proteins and disrupted the binding of the purified spike protein of SARS-CoV-2 to human ACE2. This study demonstrates that the broad-spectrum virucidal activity of highly purified HClO is attributed to viral protein aggregation of virion via protein oxidation.

KEYWORDS

hypochlorous acid, virucide, SARS-CoV-2, oxidation, protein aggregation

Hypochlorous acid is antipruritic and anti-inflammatory in a mouse model of atopic dermatitis

T. Fukuyama¹ | B. C. Martel¹ | K. E. Linder² | S. Ehling¹ | J. R. Ganchingco¹ | W. B€aumer^1,3

Summary

Background: It has been reported that topical hypochlorous acid (HOCl) formulations lead to relief of itch in human patients with atopic dermatitis; however, the specific antipruritic mechanism of action remains unclear.

Objective: To confirm itch relief and reduction of lesions in a mouse model of atopic dermatitis and to elucidate possible HOCl’s mode of action.

Methods: In this study, the effects of topical administration of HOCl hydrogel (0.05%) on atopic dermatitis-like lesions in NC/Nga mice model as well as in vitro effects of HOCl on dorsal root ganglia neurons and mouse bone marrow-derived dendritic cells (mBMDCs) were investigated. NC/Nga mice were sensitized with house dust mite allergen and treated topically with HOCl hydrogel both preventively and therapeutically against established lesions. Allergen challenge was continued during HOCl hydrogel application.

Results: Treatment with HOCl hydrogel prevented the development of lesions and scratching bouts during the whole observation period. When administered after full development of lesions, HOCl reduced lesions and scratching behaviour to a similar extent as a positive control 0.1% betamethasone dipropionate ointment. The reduced inflammatory response by HOCl treatment was demonstrated by reduced secretion of inflammatory cytokines in affected skin tissue from NC/Nga mice. In addition, HOCl significantly reduced IL-12 production in mBMDC. The diminished scratching behaviour was confirmed by impaired response to several pruritogens in dorsal root ganglia neurons excised from NC/Nga mice after termination of the studies. The response to the stimuli was also reduced by pre-incubation of sensory neurons from untreated BALB/c mice with 0.0001% HOCl. Conclusions and Clinical Relevance: These data indicate a direct reduction in sensory response by HOCl, leading to significantly reduced itch and inflammation in vivo.

KEYWORDS

atopic dermatitis, dorsal root ganglia, hypochlorous acid, IgE, IL-13, IL-4, NC/Nga mice, sensory neurons

中国肝细胞癌经动脉介入治疗 临床实践指南（2026版）

中国医师协会介入医师分会临床诊疗指南专委会

通信作者：滕皋军，东南大学附属中大医院介入与血管外科，南京 210009，Email：该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

【摘要】 经动脉介入治疗（TAI）应用于肝细胞癌（HCC），主要包括经动脉化疗栓塞（TACE）、经动脉栓塞（TAE）、肝动脉灌注化疗（HAIC）和选择性内放射治疗（SIRT）。TACE是治疗不可切除HCC的首选方法，中国医师协会介入医师分会（CCI）分别于2018、2021和2023年制订并更新了《中国肝细胞癌经动脉化疗栓塞（TACE）治疗临床实践指南》，为规范我国 TACE 临床实践发挥了重要作用。近年来，HAIC、SIRT在国内的应用日趋广泛并不断规范。随着TAI技术的进步、治疗理念的更新以及近年来高级别循证医学证据的出现，CCI在既往指南内容基础上，整合TACE、HAIC、SIRT内容并更新颁布《中国肝细胞癌经动脉介入治疗临床实践指南（2026版）》。本指南以最新循证医学证据为基础，结合我国临床实践，涵盖了TAI应用于HCC治疗的新进展，从临床诊断标准与分期、患者适应证与禁忌证、操作流程及要求、围手术期处理、常见并发症及处理、随访及疗效评价、联合治疗、质量控制及热点和展望等方面阐述，旨在进一步规范TAI在HCC治疗中的应用。

【关键词】 癌，肝细胞； 介入放射学，治疗性； 实践指南； 经动脉介入治疗

实践指南注册：国际实践指南注册与透明化平台（PREPARE‑2025CN046）

Chinese clinical practice guidelines for transarterial interventions of hepatocellular carcinoma (2026 edition)

Clinical Guidelines Committee of Chinese College of Interventionalists

Corresponding author: Teng Gaojun, Center of Interventional Radiology & Vascular Surgery, Department of Radiology, Zhongda Hospital, Southeast University, Nanjing 210009, China, Email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

【Abstract】 Transarterial interventions (TAI) for hepatocellular carcinoma (HCC) include transarterial chemoembolization (TACE), transarterial embolization (TAE), hepatic arterial infusion chemotherapy (HAIC), and selective internal radiation therapy (SIRT). TACE remains the first‑line treatment for unresectable HCC. Chinese College of Interventionalists (CCI) previously issued and updated the Chinese Clinical Practice Guidelines of TACE for HCC in 2018, 2021, and 2023, which have played a pivotal role in standardizing TACE procedures in China. In recent years, the application of HAIC and SIRT has become increasingly widespread and standardized in China. With the continuous advancement of TAI techniques, the evolution of therapeutic concepts, and the emergence of high‑level evidence, CCI has comprehensively revised and expanded its previous guidelines. The updated Chinese clinical practice guidelines for transarterial interventions of hepatocellular carcinoma (2026 edition) now formally incorporates TACE, HAIC, and SIRT as standard treatment modalities. With the aims to further standardize the use of TAI in the management of HCC, this guideline is developed based on the most current evidence‑based medical research, integrates China‑specific clinical practices, and incorporates the latest advancements in TAI for HCC. It elaborates on clinical diagnostic criteria and staging, patient indications and contraindications, operational procedures and requirements, perioperative management, common complications management, follow‑up and efficacy evaluation, combination therapy, quality control, as well as hot topics and prospects.

【Key words】 Carcinoma, hepatocellular; Interventional radiology, therapeutic; Practice guideline; Transarterial interventions

Practice guideline registration: Practice Guideline Registration for Transparency (PREPARE‑2025CN046)

Use of Bleach Baths for Atopic Dermatitis: An Indian Perspective

Nidhi Sharma, Sandipan Dhar, Abhishek De, Kiran Godse, D S Krupa Shankar, Vijay Zawar, Mukesh Girdhar, Bela Shah

Abstract

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder affecting 15–20% of children and 1–10% of adults. Staphylococcus aureus (S. aureus) infection is the most frequent complication of AD and is involved in the worsening of the disease. Systemic and topical antibiotics are used in the treatment for AD but there are concerns over increasing resistance. Bleach (sodium hypochlorite, NaOCl) baths are an inexpensive, widely accessible, alternative antibiotic treatment that may not worsen antibiotic resistance. Bleach baths are used as adjunctive treatment in AD patients to treat superinfections, although their mechanism of action is not well understood. Balancing safety concerns with efficacious treatment should be important especially for AD where the majority of patients are in pediatrics age groups. Studies available in PubMed databases were included in this review. Most suggested bleach bath improves clinical symptoms of AD and restores surface microbiome by eradicating bacteria, most notably S. aureus. Some studies have noted that this antimicrobial effect has reduced the need for topical corticosteroids. In addition, bleach seems to have strong anti-inflammatory and antipruritic effects. Overall, bleach baths seem to be safe on human skin, without disrupting the epidermal barrier function. The review concluded, although there are some advantages of use of bleach baths, more studies to investigate long-term efficacy and safety of bleach baths are required before fixing its role in the treatment of AD especially in the context of the Indian scenario.

Key Words: Atopic dermatitis, bleach baths, sodium hypochlorite

Hypochlorous Acid: Applications in Dermatology

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.

Wound pH-Modulating Strategies for Diabetic Wound Healing

Le´o-Paul Tricou,^1–3 Marie-Lynn Al-Hawat,¹ Katia Cherifi,¹ Gabriela Manrique,¹ Benjamin R. Freedman,^4,* and Simon Matoori^1,*

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