Cutaneous wound healing modulation of lesions infected by Staphylococcus epidermidis and treated with 4% stabilized sodium hypochlorite solution

Carolina Telini Rosa Rodrigues Alves Carolina Telini Rosa Rodrigues Alves,Ana Paula Girol Ana Paula Girol,Juliana Cruzera Antonio Juliana Cruzera Antonio,Melina Mizusaki Iyomasa-Pilon Melina Mizusaki Iyomasa-Pilon,Eduardo Monteiro Diniz Junqueira Eduardo Monteiro Diniz Junqueira,Camillo De Lellis Sandoval Filho Camillo De Lellis Sandoval Filho,Helena Ribeiro Souza Helena Ribeiro Souza

doi:10.30574/wjbphs.2021.7.2.0077

Carolina Telini Rosa Rodrigues Alves Carolina Telini Rosa Rodrigues Alves, Ana Paula Girol Ana Paula Girol + Show 5 more

Open Access

https://doi.org/10.30574/wjbphs.2021.7.2.0077

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Abstract

Background: Stabilized sodium hypochlorite solution at 4% (4% NaClO) is a product with healing properties but still little studied scientifically. Here we evaluated the administration of 4% NaClO in a model of clean and infected skin lesions. Methods: Lesions were obtained on the dorsal region of Wistar rats. The wounds of some animals were inoculated with Staphylococcus epidermidis (50uL, 10-7) and clean and infected lesions were treated with Trofodermin® or 4% NaClO (diluted at 0.4%) as the following groups: Trofodermin®; S. epidermidis + Trofodermin®; 4% NaClO; S. epidermidis + 4% NaClO. Wounds sizes were daily measured and the excision of lesions was performed on day 8 for histopathological evaluation and immunohistochemical studies of Annexin A1 (AnxA1), receptors for formylated peptides (FPR)1 and FPR2 and vascular endothelial growth factor (VEGF). Levels of interleukin (IL)-1β and tumor necrosis factor (TNF)-α in the supernatants of the macerated lesions were also measured. Results: Wounds treated with 4% NaClO closed faster than those treated with Trofodermin®, especially in the infected group. 4% NaClO reduced the expressions of AnxA1, FPR1, FPR2 and VEGF, as well as decreased the levels of IL-1β. Conclusion: These results pointed the potential of 4% NaClO in wound healing which opens the possibility for new therapeutic strategies.

Highlights

The skin healing involves a cascade of events that promotes wound healing and restores the anatomy of the skin
The treatment with 4% NaClO was effective in wound healing The morphological evaluations indicated that the lesions healed faster in the groups treated with 4% NaClO compared to animals treated with Trofodermin®, especially in the group with infected lesions (Figure 3E)
These findings were corroborated by histopathological analysis that showed faster reepithelization, rearrangement of the dermis and reappearance of epithelial attachments by treatment with 4% NaClO (0.4%) compared to the groups treated with Trofodermin® (Figure 3A-D)

Summary

Introduction

The skin healing involves a cascade of events that promotes wound healing and restores the anatomy of the skin. Models of wounds mainly infected by bacteria were proposed for testing new therapies [13], since the infection by microorganisms is one of the risk factors in patients In this context, chlorinated products like sodium hypochlorite (NaClO) is proven to be microbiocidal for disinfection of surfaces [14,15,16] and in addition they have shown therapeutic applicability, as dental root canal irrigants [17], skin decontamination [18,19] and wound healing [20,21,22,23]. Wounds sizes were daily measured and the excision of lesions was performed on day 8 for histopathological evaluation and immunohistochemical studies of Annexin A1 (AnxA1), receptors for formylated peptides (FPR) and FPR2 and vascular endothelial growth factor (VEGF).

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