# Patent

## Title
Methods of treating or preventing peritonitis with oxidative reductive potential water solution

## Abstract

Provided is a method for treating or preventing peritonitis by administering a therapeutically effective amount of an oxidative reduction potential (ORP) water solution that is stable for at least about twenty-four hours. The ORP water solution administered in accordance with the invention can be combined with one or more suitable carriers and can be administered in conjunction with one or more additional therapeutic agents. Further provided is a method for preventing peritoneal hemorrhage, adhesions and abscesses.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This patent application claims the benefit of U.S. Provisional Patent Application Nos. 60/760,635 filed Jan. 20, 2006; 60/760,567 filed Jan. 20, 2006; 60/760,645 filed Jan. 20, 2006; and 60/760,557 filed Jan. 20, 2006; all of which are hereby incorporated by reference in their entireties.


BACKGROUND OF THE INVENTION
Peritonitis is an inflammation of the internal lining of the abdominal cavity. The most common causes of peritonitis are bacterial infection and chemical irritation. Bacterial peritonitis is usually secondary to bacterial penetration through an abdominal organ as occurs with disorders such as appendicitis, acute cholecystitis, peptic ulcers, diverticulitis, bowel obstruction, pancreatitis, mesenteric thrombosis, pelvic inflammatory disease, tumor or penetrating trauma, or combinations thereof. In addition, spontaneous bacterial peritonitis (SBP) can develop without an obvious source of contamination. SBP is frequently associated with immunosuppressed states, such as cirrhotic ascites or the nephrotic syndrome. Peritonitis is also a common complication of chronic ambulatory peritoneal dialysis (CAPD).
Although virtually every organism has been implicated in bacterial peritonitis, the most common organisms are Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, C. perfingens, Neisseria gonorrhea, Chlamydia trachomatis, Mycobaterium tuberculosis, Chlamydia trachomatis, Clostridium perfringens, streptococci and enteroococci. The most common fungal agents to cause infectious peritonitis are Candida albicans, Candida parapsilasis, and Aspergillus fumigaus. Non-infectious chemical peritonitis can result from foreign materials introduced into the peritoneum, for example, during surgery or by trauma. Chemical peritonitis can also develop in conditions, such as acute pancreatitis, which introduce irritating endogenous materials, such as digestive enzymes or bile, into the peritoneal cavity.
Peritoneal adhesions and abscesses are frequent long-term complications of peritonitis. Peritoneal adhesions are abnormal fibrous tissue connections between intraperitoneal serosal surfaces. Surgery and abdominal inflammation are the most common causes of peritoneal adhesions. Peritoneal infection is often accompanied by peritoneal inflammation, including exudation of fibrinogen and fibrin into the abdominal cavity. The presence of fibrinogen and fibrin promotes fibrosis and adhesion formation.
Inflammation also results in the intraperitoneal accumulation of growth factors, cytokines, proteases, and extracellular matrix which further promotes fibrosis and adhesion formation. In infectious peritonitis, fibrin deposits may trap infectious agents resulting in abscesses, which in turn can cause more fibrous adhesions. Peritoneal adhesions limit the normal motion and function of the intra-abdominal organs, particularly the normal function of gastrointestinal tract. Peritoneal adhesions also can result in pelvic pain, infertility, and ischemic bowel obstructions.
Peritoneal abscesses are walled-off collections of microorganisms and inflammatory cells and mediators (i.e., “pus”). Peritoneal abscesses are difficult to treat because they are walled-off by fibrous capsules making it difficult to achieve therapeutic levels of antibiotics within peritoneal abscesses. Peritoneal abscesses can be the source of serious infections in distant organs, and sepsis. Thus, peritoneal adhesions and abscesses are a major cause of morbidity and mortality. The effective treatment or prevention of peritonitis can significantly reduce the risk of developing intraperitoneal adhesions and abscesses.
The methods currently used for treating or preventing peritonitis are limited. In some cases, chemical peritonitis can respond to irrigation of the abdominal cavity. The use of multiple re-explorations and intra-operative lavage with large amounts of sterile saline solution has been recommended to decrease the risk of post-operative peritoneal infection, peritonitis and adhesions. However, there is still a significant risk of developing peritonitis and adhesions despite the use of repeated lavages with sterile saline. Various topical antimicrobials have also been tested but none has been widely accepted for source control due to either, lack of efficacy or serious side effects (i.e. sclerosing peritonitis). Further, systemic antibiotic therapy is often required, even if the condition is originally chemical in etiology.
Depending on the type and severity of the peritonitis, the clinical picture could progress to an acute systemic inflammatory response syndrome (SIRS), sepsis or septic shock. The physiopathology of these conditions is complex but it can be associated with the presence of infection and of an acute inflammatory reaction both, locally and systemically. Thus, even in early stages (i.e. SIRS), there is accumulation of pro-inflammatory cytokines in the peritoneal cavity and in the blood that contribute to the establishment of multi-organ failure and death. These cytokines, at least in murine peritonitis models, are mostly derived from activated mast cells in the peritoneal cavity.
Accordingly, there is a need for improved methods of treating or preventing peritonitis. The present invention provides such methods. These and other advantages of the invention, as well as additional inventive features, will be apparent from the description of the invention provided herein.
BRIEF SUMMARY OF THE INVENTION
The present invention provides a method of treating or preventing peritonitis, which method includes administering to the patient (e.g., contacting peritoneal tissue in the patient with) a therapeutically effective amount of an oxidative reductive potential (ORP) water solution, wherein the solution is stable for at least about twenty-four hours. In accordance with the present invention, a therapeutically effective amount of the ORP water solution can be administered by delivering the ORP water solution to the peritoneal (or other) tissue using any suitable delivery method, to treat or prevent peritonitis (or to prevent local adhesions, peritoneal abscesses, systemic inflammatory response syndrome and multi-organ failure associated therewith). A therapeutically effective amount of the ORP water can be delivered to the patient's peritoneal space intra-operatively, laproscopically, or transabdominally. The ORP water solution can be delivered, e.g., to peritoneal tissue affected by peritonitis or to peritoneal tissue that is at risk for developing peritonitis (e.g., as a result of surgery, laparoscopic-diagnostic procedures, injury, infection, disease, allergic reaction, contact with one or more chemical irritants, or proximity to impaired, damaged and/or infected tissue, and the like).
Peritoneal lavage, e.g., repeated flushings of the peritonium, with the ORP water solution can be used to perform the method of the present invention. The ORP water solution can be retained in the peritoneal cavity for any suitable length of time, e.g., a period of time effective to provide a therapeutic response, which can be seconds, minutes, hours, or days. In one embodiment, the present invention provides a method of treating or preventing peritonitis, which method includes gaining access to the peritoneal space, e.g., surgically or transabdominally; delivering to the patient's peritoneal space of a therapeutically effective amount of the ORP water solution, e.g., about 1-10 liters, allowing the water to remain in peritoneal space for a period of time sufficient to effectuate a therapeutic response, e.g., seconds, minutes, or hours; optionally removing the ORP water solution from the peritoneal space; optionally, removing the ORP water solution from the peritoneal space; optionally, delivering saline or other physiologic solution prior or after delivering the ORP water; and optionally, repeating the peritoneal lavage for as many times as necessary.
The present invention further provides a method of preventing peritoneal adhesions or peritoneal abscesses in a patient, which method includes administering to the patient (e.g., contacting peritoneal tissue in the patient with) a therapeutically effective amount of an oxidative reductive potential (ORP) water solution, wherein the solution is stable for at least about twenty-four hours.
The systemic inflammatory response syndrome (SIRS), a syndrome that encompasses the features of systemic inflammation without end-organ damage or identifiable bacteremia. SIRS is separate and distinct from sepsis, severe sepsis or septic shock. The key transition from SIRS to sepsis is the presence of an identified pathogen in the blood. The pathophysiology of SIRS includes, but is not limited to, complement activation, cytokine and arachidonic acid metabolites secretion, stimulated cell-mediated immunity, activation of the clotting cascades, and humoral immune mechanisms. Clinically SIRS is characterized by tachycardia, tachypnea, hypotension, hypoperfusion, oliguria, leukocytosis or leukopenia, pyrexia or hypothermia, metabolic acidosis, and the need for volume support. SIRS may affect all organ systems and may lead to multiple organ dysfunction syndrome (MODS).
Accordingly, the present invention further provides a method of preventing multi-organ failure secondary to peritonitis and related to the development of SIRS or sepsis, which method includes administering to the patient (e.g., contacting peritoneal tissue in the patient with) a therapeutically effective amount of an oxidative reductive potential (ORP) water solution to inhibit the secretion of new pro-inflammatory molecules from mast cells and reduce the bacterial load, wherein the solution is stable for at least about twenty-four hours.
The ORP water solution can be administered in any suitable form in accordance with the present invention, e.g., as a liquid, spray, mist, aerosol or steam, alone or in combination with one or more additional therapeutic agents, and, if desired, can be formulated in combination with one or more suitable carriers, e.g., vehicles, adjuvants, excipients, diluents, and the like.
The ORP water solution administered in accordance with the present invention can be contained within a suitable container (e.g., a sealed, sterile container) in which the solution is stable for at least about twenty-four hours. The ORP water solution administered in accordance with the invention can be produced by electrolysis, and preferably comprises a mixture of anode water and cathode water, which contains one or more species, including, e.g., one or more reactive species, ionic species, radical species, precursors thereof and combinations thereof.
In another embodiment, the ORP water solution comprises hypochlorous acid in an amount of from about 15 ppm to about 35 ppm, sodium hypochlorite in an amount of from about 25 ppm to about 50 ppm, is stable for at least about one week, and has a pH of from about 6.2 to about 7.8. The total amount of oxidizing chemical species present in the ORP water solution is preferably in the range of about 2 millimolar (mM) and can include the aforementioned chlorine species, one or more additional superoxidized water species (e.g., one or more oxygen species), and additional species that may be difficult to measure such as Cl−, ClO3, Cl2−, and ClOx.



BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 illustrates a three-chambered electrolysis cell for producing an exemplary ORP water solution.
FIG. 2 illustrates a three-chambered electrolysis cell and depicts ionic species that are believed to be generated during the production process.
FIG. 3 is a schematic flow diagram of a process for producing an exemplary ORP water solution.
FIG. 4A-4C depicts a graphical comparison of cell viability, apoptosis and necrosis in human dermal fibroblasts (HDFs) treated with an exemplary ORP water solution (MCN) versus hydrogen peroxide (HP).
FIG. 5 is a graphical comparison of the levels of 8-hydroxy-2′-deoxiguanosine (8-OHdG) adducts in HDFs treated with an exemplary ORP water solution (MCN) versus 500 μM hydrogen peroxide (HP).
FIG. 6 illustrates cellular senescence demonstrated by β-galactosidase expression in HDFs after chronic exposure to low concentrations of an exemplary ORP water solution (MCN) versus hydrogen peroxide (HP).
FIG. 7 illustrates the effect on degranulation of antigen-activated mast cells treated with various concentrations of an exemplary ORP water solution (MCN).
FIG. 8 comparatively illustrates the effect of an exemplary ORP water solution (MCN) on degranulation of antigen-activated mast cells treated with cromoglycate.
FIG. 9 illustrates the effect on degranulation of antigen-activated and calcium ionophore (A23187)-activated mast cells treated with various concentrations of an exemplary ORP water solution (MCN).
FIG. 10A-10B are RNAse protection assays illustrating cytokine mRNA levels after antigen challenge in control versus ORP water solution-treated mast cells.
FIG. 11 is a graphical comparison of TNF-α secretion by antigen-activated mast cells treated with various concentrations of an exemplary ORP water solution (MCN).
FIG. 12 is a graphical comparison of MIP1-α secretion by antigen-activated mast cells treated with various concentrations of an exemplary ORP water solution (MCN).
FIG. 13 is a graphical comparison of IL-6 secretion by antigen-activated mast cells treated with various concentrations of an exemplary ORP water solution (MCN).
FIG. 14 is a graphical comparison of IL-13 secretion by antigen-activated mast cells treated with various concentrations of an exemplary ORP water solution (MCN).



DETAILED DESCRIPTION OF THE INVENTION
The present invention provides a method for treating or preventing peritonitis, for preventing adhesions or abscesses associated therewith, and for preventing the development of SIRS and multiple organ failure in these cases, which method includes administering to the patient (e.g., contacting peritoneal tissue in the patient with) a therapeutically effective amount of an oxidative reductive potential (ORP) water solution, wherein the solution is stable for at least about twenty-four hours. In accordance with the invention, the ORP water solution can be administered, e.g., to patients that have peritonitis, have symptoms indicative of or associated with peritonitis, or that are at risk for developing peritonitis (e.g., due to surgery, invasive diagnostic procedures (e.g. laparoscopy, endoscopy), injury, infection, disease, allergy, allergic reaction, contact with one or more chemical irritants, and the like). Another potential source of peritonitis due to infection could be organ transplantation. Thus, the ORP water solution could be used to prepare the tissue bed prior to transplantation and/or prior to closure of the abdomen.
The ORP water solution administered in accordance with the invention is effective for treating or preventing (e.g., inhibiting the onset of, inhibiting the escalation of, decreasing the likelihood of, or limiting) peritonitis, and can further prevent the formation of adhesions and/or abscesses and the development of IRS and multiple organ failure associated therewith. The ORP water solution administered in accordance with the invention has potent anti-inflammatory, anti-allergic and anti-infective activity, yet is virtually free of toxicity to normal tissues and normal eukaryotic cells.
Clinically, the ORP water solution administered in accordance with the invention has been found to be safe and effective for reducing peritoneal bacterial load, and has been found to reduce the length of hospital stay, in patients with peritonitis. The peritonitis treatable or preventable in accordance with the present invention can include peritonitis that results from, e.g., bacterial infection, chemical irritation, hemorrhage, or a combination thereof. The method of the present invention can be carried out by administering a therapeutically effective amount of the ORP water solution to a patient that has peritonitis or a patient that is at risk of developing peritonitis, e.g., from infection, exposure to one or more infectious microorganisms, prolonged surgeries, contact with one or more chemical irritants, disease or other physiological condition that can give rise to peritonitis, and combinations thereof.
The method of the present invention can be used for the treatment or prevention of peritonitis, which results from, e.g., surgery, invasive diagnostic or therapeutic procedures (e.g., using laparoscopy, endoscopy), appendicitis, acute cholecystitis, peptic ulcers, diverticulitis, bowel obstruction, pancreatitis, pelvic inflammatory disease, tumor, dyalsis or injury, e.g., penetrating trauma. The method of the present invention includes treating or preventing peritonitis (or preventing adhesions or abscesses) caused or complicated (e.g., exacerbated) by infection, which is preferably carried out by administering the ORP water solution in an amount effective to reduce the peritoneal microbial load of one or more susceptible microorganisms. This peritonitis can include, without limitation, spontaneous bacterial peritonitis, which can occur in an immunosuppressed patient, wherein the immunosupression is associated with, e.g., congenital or acquired immunodeficiency, infection, cancer, lymphoma, leukemia, autoimmune disease, malnutrition, immunosuppressive drugs, hepatic cirrhosis, and the nephrotic syndrome.
In accordance with this aspect of the invention, it is desirable to reduce the peritoneal microbial load sufficiently to treat or prevent peritonitis, to reduce the inflammatory or allergic reactions and/or to prevent adhesions or abscesses, which can result from infection (e.g.; by one or more susceptible microorganisms), inflammation and bleeding. Susceptible microorganisms can include, e.g., viruses, bacteria, spores and fungi. Examples of susceptible bacteria include, but are not limited to, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, C. perfingens, Neisseria gonorrhea, Chlamydia trachomatis, Mycobaterium tuberculosis, Chlamydia trachomatis, Clostridium perfringens, streptococci, enteroococci, and combinations thereof. Examples of susceptible fungi include, but are not limited to, Candida albicans, Candida parapsilasis, Trichophyton mentagrophytes, and Aspergillus fumigaus, and combinations thereof. Examples of susceptible viruses can include one or more susceptible viruses described herein.
The invention also provides methods for killing bacteria in biofilms, e.g., Pseudomonas aeruginosa in biofilms. The invention further provides methods for killing of Moraexlla catarrhalis and antibiotic resistant bacteria, e.g., penicillin resistant Streptococcus. The methods disclosed herein can be used in accordance with the invention for killing bacteria using ORP water solutions faster than with using Bacitracin.
The method of the present invention also can be effective for treating or preventing peritonitis (or preventing adhesions or abbesses associated therewith), which are not necessarily caused by infection. Such inflammation can include inflammation caused by, e.g., allergic reaction, contact with and/or exposure to one or more irritants (e.g., chemical irritants), hemorragic diathesis, and combinations thereof. Such inflammation also can include inflammation that results from the impairment or damage of tissue, e.g., peritoneal or other tissue, in which the impairment or damage can lead to or increase the likelihood of peritonitis. Tissues, which can be so impaired or damaged can include, e.g., the peritoneal lining, mesentery, omenta, abdominal organs, pelvic organs, and one or more tissues in the retroperitoneal space. The impairment or damage can be caused by, without limitation, surgery, laparoscopy, endoscopy, injury, disease, (e.g., cancer, blood disease, organ disease, tissue disease, and the like), dialysis and combinations thereof.
The method of the present invention also can be effective for treating or preventing peritonitis (or preventing adhesions or abscesses) associated with impaired or damaged tissue colonized or infected with one or more microorganisms such as, e.g., viruses, bacteria, and/or fungi, which are susceptible to the ORP water solution administered in accordance with the invention. Susceptible bacteria can include, e.g., Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, C. perfingens, Neisseria gonorrhea, Chlamydia trachomatis, Mycobaterium tuberculosis, Chlamydia trachomatis, Clostridium perfringens, streptococci sp., enteroococci, and combinations thereof. Susceptible fungi can include, e.g., Candida albicans, Candida parapsilasis, and Aspergillus fumigaus, and combinations thereof. Susceptible viruses can include one or more susceptible viruses described herein.
The method of the present invention still further includes preventing (e.g., inhibiting the onset of, inhibiting the escalation of, decreasing the likelihood of, or limiting) SIRS and multi-organ failure in a patient with peritonitis by delivering to the patient's peritoneal space, a therapeutically effective amount of an ORP water solution, wherein the solution is stable for at least twenty-four hours. While not wishing to be bound by any particular theory, it is believed that the ORP water solution administered in accordance with the present invention treats or prevents the underlying inflammatory process in the peritoneal cavity required for the development of SIRS and multi-organ failure. Further, it is believed that the ORP water solution administered in accordance with the invention inhibits the secretion of pro-inflammatory molecules which can accumulate in the peritoneal cavity during peritonitis. Accordingly, it is believed that administering the ORP water solution in an amount effective to treat or prevent even subclinical peritonitis can prevent the progression to SIRS and multi-organ failure.
Surprisingly, it has been found that the ORP water solution administered in accordance with the invention is a highly effective inhibitor of mast cell degranulation, one of the primary inflammation-causing biological cascades in peritonitis. The ORP water solution administered in accordance with the invention inhibits degranulation of mast cells regardless of whether they are activated with an antigen or a calcium ionophore. Also surprisingly, it has been found that the ORP water solution administered in accordance with the present invention non-selectively inhibits the secretion of pro-inflammatory cytokines in mast cells. For example, the ORP water solution of the present invention can inhibit the secretion of, e.g., TNF-α, MIP1-α, IL-6, and IL-13 in mast cells. It is believed that the ORP water solution administered in accordance with the invention also can inhibit the secretion of pro-inflammatory cytokines in other cytokine-secreting cells. These findings demonstrate that the ORP water solution administered in accordance with the present invention should exhibit broad anti-allergic and anti-inflammatory efficacy, which is desirable for treating or preventing peritonitis, for preventing adhesions and abscesses associated therewith, and for preventing the establishment to SIRS and multi-organ failure that worsens the prognosis in these cases. A hemostatic effect is also believed to have been possibly observed in clinical practice and this property could be yet another mechanism by which the ORP water solution could reduce fibrosis and abscess formation. Although applicants do not wish to be bound by any particular theory, it is believed that, to prevent peritoneal adhesions, abscesses, SIRS and multi-organ failure, may be due to a combined antimicrobial, anti-allergic, and anti-inflammatory activity, the ORP water solution may even possibly provide a hemostatic effect sufficient to completely ameliorate hematomas (interstitial blood clots).
The ORP water solution administered in accordance with the invention preferably inhibits mast cell degranulation by more than about 50% relative to untreated mast cells, more preferably by more than about 80% relative to untreated mast cells, still more preferably by more than about 90% relative to untreated mast cells, and even more preferably by more than about 95% relative to untreated mast cells, when contacted with the ORP water solution for up to about 30 minutes, more preferably for up to about 15 minutes, and still more preferably for up to about 5 minutes. In accordance with the method of the invention, histamine secretion (e.g., from degranulation) can be therapeutically inhibited by the administration of the ORP water solution alone or in combination with a diluent (e.g., water or saline solution). For instance, histamine secretion can be therapeutically inhibited by administering compositions in which the ORP water solution is diluted, e.g., by a ratio of up to about 50% (vol./vol.) ORP water solution/diluent, by a ratio of up to about 25% (vol./vol.) ORP water solution/diluent, by a ratio of up to about 10% (vol./vol.) ORP water solution/diluent, by a ratio of up to about 5% (vol./vol.) ORP water solution/diluent, or even by a ratio of up to about 1% (vol./vol.) ORP water solution/diluent.
The ORP water solution administered in accordance with the invention also preferably inhibits the secretion of TNF-α by more than about 50%, more preferably by more than about 60%, still more preferably by more than about 70%, and even more preferably by more than about 85%. In addition, the ORP water solution administered in accordance with the invention also preferably inhibits the secretion of MIP1-α by more than 25%, more preferably by more than about 50%, and still more preferably by more than about 60%. Further, the ORP water solution administered in accordance with the invention also preferably inhibits the secretion of IL-6 or IL-13 by more than 25%, more preferably by more than about 50%, and still more preferably by more than about 60%. In accordance with the method of the invention, cytokine secretion can be therapeutically inhibited by the administration of the ORP water solution alone or in combination with a diluent (e.g., water or saline solution). For instance, cytokine secretion can be therapeutically inhibited by administering compositions in which the ORP water solution is diluted, e.g., up to about 50% (vol./vol.) ORP water solution/diluent, up to about 25% (vol./vol.) ORP water solution/diluent, up to about 10% (vol./vol.) ORP water solution/diluent, up to about 5% (vol./vol.) ORP water solution/diluent, or even up to about 1% (vol./vol.) ORP water solution/diluent.
The ORP water solution administered in accordance with the invention can be used for treating or preventing cell-mediated inflammation and inflammation, which results from an autoimmune reaction including, but not limited to, inflammation resulting from SLE, autoimmune thyroiditis, sarcoidosis, inflammatory bowel disease, rheumatoid arthritis, and rheumatic fever. The ORP water solution administered in accordance with the invention also can treat or prevent inflammation, which results from infection, e.g., by one or more microorganisms selected from the group consisting of viruses, bacteria, and fungi, including hypersensitivity and autoimmune-mediated inflammation resulting from infection.
The ORP water solution administered in accordance with the invention also can be used for treating or preventing inflammation associated with hypersensitivity. Historically, hypersensitivity reactions have been classified as one of four types, from which significant disease can result. The ORP water solution administered in accordance with the invention can be used to treat and/or prevent (e.g., inhibit the onset of, inhibit the escalation of, decrease the likelihood of, limit or suppress) one or more of such reactions. Type I hypersensitivity typically results from the combination of an antigen with an antibody bound to a mast cell or basophil. Type I reactions occur within minutes of exposure to the antigen in individuals who have been previously sensitized to the antigen. In humans, Type I reactions are mediated by IgE which has high affinity Fc receptors on mast cells and basophils.
Mast cells' role in Type I hypersensitivity is especially important because they reside in tissues under the epithelial surface near blood vessels and nerves. Multiple clinical symptoms observed in atopic dermatitis, allergic rhinitis and atopic asthma are produced by IgE-antigen stimulation of mast cells located in distinct affected tissues. The currently accepted view of the pathogenesis of conditions such as atopic asthma is that allergens initiate the process by triggering IgE-bearing pulmonary mast cells (MCs) to release mediators such as histamine, leukotrienes, prostaglandins, kininis, platelet activating factor (PAF), etc. in the so-called early phase of the reaction (see Kumar et al., Robbins & Cotran Pathologic Basis of Disease, 2004, pp. 193-268, which is hereby incorporated by reference). In turn, these mediators induce bronchoconstriction and enhance vascular permeability and mucus production. According to this model, following mast cell activation, those cells secrete various cytokines, including tumor necrosis factor alpha (TNF-α), IL-4, IL-5 and IL-6, which participate in the local recruitment and activation of other inflammatory cells such as eosinophils, basophils, T lymphocytes, platelets and mononuclear phagocytes. These recruited cells, in turn, contribute to the development of an inflammatory response that may then become autonomous and aggravate the asthmatic symptoms. This late phase response constitutes a long term inflammatory process which will induce changes in surrounding tissues (Kumar et al., pp. 193-268). Clinically, Type I reactions can have local effects such as allergic rhinitis, or systemic effects as is found in anaphylaxis, which can manifest itself with itching, hives, respiratory distress, and circulatory collapse.
Type II hypersensitivity is mediated by antibodies directed to antigens on the surfaces of cells and in the extracellular space. These antibodies can direct cell lysis or result in opsonization of the target molecules (preparation for phagocytosis by other cells). Alternatively, the antibodies can be directed to and activate cell surface receptors. Conditions resulting from Type II reactions include transfusion reactions, Graves disease (thyrotoxicosis), drug reactions, pernicious anemia, and acute rheumatic fever. In rheumatic fever, the antibodies are formed against Streptococcal antigens but cross-react with human tissues such as heart valves.
Type III hypersensitivity is caused by immune complexes, which are combinations of antibodies and other host immune system proteins, most typically complement proteins. It is the normal function of antibodies to bind and actively complement. However, when the resulting macromolecular immune complexes are not adequately processed, they can lead to persistent tissue damage. Macrophages and PMNLs can be activated by immune complexes and lead to the release of toxic chemicals by these cells. Immune complex reactions can be local and may result in conditions such as, e.g., the arthus reaction or cause systemic disease such as serum sickness or some of the aspects of systemic lupus erythematous (SLE).
Type IV hypersensitivity is cell mediated and is sometimes called delayed-type hypersensitivity. Type IV hypersensitivity is mediated by T lymphocytes and often results in the formation of a granulomatous reaction. In a granulomatous reaction, a form of macrophage called an epitheloid cell attempts to, but fails, to digest an antigen. The antigen's persistence leads to the release of cytokines that attract additional lymphocytes resulting in chronic foci of inflammation. The foci have high concentrations of cyotoxic T-lymphocytes which release granzymes and perforins which are toxic to adjacent cells. Type IV hypersensitivity is a prominent component of autoimmune diseases such as, e.g., Sjogrren's Syndrome, Sarcoidosis, and contact dermatitis.
Pathologic states can combine different types of hypersensitivity reactions. In autoimmune diseases host antigens stimulate hypersensitivity with serious consequences for the host. For example, in SLE host antigens induce Type II reactions against blood cells while Type III reactions lead to blood vessel and renal glomerular damage. In addition, hypersensitivity reactions are also observed in iatragenic conditions such as drug reactions and transplant rejection. Transplant rejection includes components of Type II and Type IV hypersensivity.
It has been found that the ORP water solution administered in accordance with the invention is virtually free of toxicity to normal tissues and normal mammalian cells. The ORP water solution administered in accordance with the invention preferably causes no significant decrease in the viability of eukaryotic cells, no significant increase in apoptosis, no significant acceleration of cell aging and/or no significant oxidative DNA damage in mammalian cells. The non-toxicity is particularly advantageous, and perhaps even surprising, given that the disinfecting power of the ORP water solution administered in accordance with the invention is roughly equivalent to that of hydrogen peroxide, yet is significantly less toxic than hydrogen peroxide is to normal tissues and normal mammalian cells. These findings demonstrate that the ORP water solution administered in accordance with the present invention is safe for use, e.g., in mammals, including humans.
Preferably, the ORP water solution administered in accordance with the present invention causes no significant decrease in the viability of mammalian cells, and/or no significant increase in apoptosis, acceleration of cell aging and/or oxidative DNA damage in mammalian cells. The cell viability rate is preferably at least about 65%, more preferably at least about 70%, and still more preferably at least about 75% after from about 5 to about 30 minutes of exposure to the ORP water solution.
The ORP water solution administered in accordance with the invention preferably causes only up to about 10% of cells, more preferably only up to about 5% of cells, and still more preferably only up to about 3% of cells, to expose Annexin-V on their cellular surfaces when contacted with the ORP water solution for up to about thirty minutes or less (e.g., after about thirty minutes or after about five minutes of contact with the ORP water solution).
The ORP water solution administered in accordance with the invention preferably causes less than about 15% of cells, more preferably less than about 10% of cells, and still more preferably less than about 5% of cells to express the SA-β-galactosidase enzyme after chronic exposure to the OPR water solution. The ORP water solution administered in accordance with the invention preferably causes only a fraction of the oxidative DNA adduct formation caused by hydrogen peroxide in cells treated under equivalent conditions, e.g., less than about 20% of the oxidative DNA adduct formation, less than about 10% of the oxidative DNA adduct formation, or about 5% or less of the oxidative DNA adduct formation normally caused by hydrogen peroxide in cells treated under equivalent conditions.
The ORP water solution administered in accordance with the invention produces no significant RNA degradation. Accordingly, RNA extracted from human cell cultures after about 30 minutes of exposure to the ORP water solution or after about 3 hours of exposure, and analyzed by denaturing gel electrophoresis, will typically show no significant RNA degradation and will typically exhibit two discreet bands corresponding to the ribosomal eukaryotic RNAs (i.e. 28S and 18S) indicating that the ORP water solution administered in accordance with the invention leaves the RNA substantially intact. Similarly, RNA extracted from human cell cultures after about 30 minutes of exposure to the ORP water solution or after about 3 hours of exposure, can be subjected reverse transcription and amplification (RT-PCR) of the constitutive human GAPDH (Glyceraldehyde-3-phosphate dehydrogenase) gene and result in a strong GAPDH band on gel electrophoresis of the RT-PCR products. By contrast, cells treated with HP for a similar period show significant RNA degradation and little if any GAPDH RT-PCR product.
In accordance with the present invention, a therapeutically effective amount of the ORP water solution can be administered by any suitable method. Suitable methods can include, e.g., contacting one or more tissues with an amount of the ORP water solution effective to treat or prevent peritonitis, reduce capillary bleeding, prevent the development of peritoneal abscesses and adhesions or prevent the progression to SIRS and multi-organ failure. An exemplary method of administration includes delivering a therapeutically effective amount of the ORP water solution to the peritoneal space, e.g., intra-operatively, under laparoscopic control, or transabdominally.
A therapeutically effective amount of the ORP water solution can be delivered to the peritoneal space, e.g., by gravity (e.g., by pouring or dispensing the ORP water solution from a container or device) or by delivering the ORP water solution under pressure (e.g., by spraying). One or more flushings of the peritonium can be performed, i.e., the peritonium can be “lavaged.” The ORP water solution can be retained in the peritoneal cavity for any suitable length of time, e.g., a period of time effective to provide a therapeutic response, e.g., seconds, minutes, hours, or days, and optionally removed using any suitable method. Suitable methods of removal can include, e.g., allowing the ORP water solution to be naturally absorbed into one or more surrounding tissues, blotting with one or more absorbent materials (e.g., gauze, sponge, towel, or mesh), removal by suction, and the like, and combinations thereof.
In one embodiment, the method of the present invention includes:
accessing the peritoneal space in a patient, e.g., that has or is at risk of developing peritonitis or that is at risk of developing adhesions or abscesses associated with peritonits;
delivering to the patient's peritoneal space a volume of the ORP water solution that is sufficient to contact peritoneal tissue with a therapeutically effective amount thereof;
allowing the ORP water solution to remain in the peritoneal space for a period of time sufficient to provide a therapeutic effect;
optionally removing the ORP water solution from the peritoneal space; and
optionally repeating the peritoneal lavage.
The peritoneal space can be accessed by any suitable method, e.g., surgically or transabdominally, through the opening of an existing wound, and the like. Any suitable volume of the ORP water solution can be delivered to the peritoneal space, e.g., from about 0.01 to about 10 liters (e.g., from about 0.1 to about 10 liters, from about 0.2 to about 10 liters, from about 0.5 to about 10 liters, or from about 1 to about 10 liters). The ORP water solution can optionally be removed and, if desired, the lavages repeated, e.g., as described herein. The lavage(s) can be performed alone or in combination with additional therapies, e.g., in combination with one or more sterile saline lavages, antibiotic therapy, and combinations thereof.
The ORP water solution can be administered parenterally, endoscopically, through a dialysis catheter or directly to the surface of any affected biological tissue, which may include the skin and/or one or more mucosal surfaces. Parenteral administration can include, for example, administering the ORP water solution intraperitoneally, intramuscularly, subcutaneously, intravenously, intra-arterially, intrathecally, intravesically or into a synovial space. Endoscopic administration of the ORP water solution can include using, e.g., bronchoscopy, colonoscopy, sigmoidoscopy, hysterscopy, laproscopy, athroscopy, gastroscopy or a transurethral approach. Administering the ORP water solution to a mucosal surface can include, e.g., administration to an esophageal, gastric, intestinal, peritoneal, urethral, vesicular, vaginal, uterine, fallopian, synovial mucosal surface, and nasal, and also can include administering the solution to an oral, tracheal, or bronchial mucosal surface.
Parenteral administration also can include administering the ORP water solution intraperitoneally, subcutaneously or intramuscularly, as well as intravenously, e.g., as described, e.g., in U.S. Pat. Nos. 5,334,383 and 5,622,848 (hereby incorporated by reference), which describe methods of treating viral myocarditis, multiple sclerosis, and AIDS via intravenous administration of ORP water solutions.
In accordance with the invention, the ORP water solution used can be administered topically, e.g., as a spray, mist, aerosol or steam, by any suitable method, e.g., by aerosolization, nebulization or atomization, e.g., in the form of droplets having a diameter in the range of from about 0.1 micron to about 100 microns, preferably from about 1 micron to about 10 microns. Methods and devices, which are useful for aerosolization, nebulization and atomization, are well known in the art. Medical nebulizers, for example, have been used to deliver a metered dose of a physiologically active liquid into an inspiration gas stream, e.g., for inhalation by a recipient. See, e.g., U.S. Pat. No. 6,598,602 (hereby incorporated by reference). Medical nebulizers can operate to generate liquid droplets, which form an aerosol, e.g., with an inspiration gas. In other circumstances medical nebulizers have been used to inject water droplets into an inspiration gas stream to provide gas with a suitable moisture content to a recipient, which is particularly useful where the inspiration gas stream is provided by a mechanical breathing aid such as a respirator, ventilator or anaesthetic delivery system.
U.S. Pat. No. 5,312,281 (hereby incorporated by reference) describes an ultrasonic wave nebulizer, which atomizes water or liquid at low temperature and reportedly can adjust the size of mist. In addition, U.S. Pat. No. 5,287,847 (hereby incorporated by reference) describes a pneumatic nebulizing apparatus with scalable flow rates and output volumes for delivering a medicinal aerosol to neonates, children and adults. Further, U.S. Pat. No. 5,063,922 (hereby incorporated by reference) describes an ultrasonic atomizer. The ORP water solution also may be dispensed in aerosol form as part of an inhaler system for treatment of infections in the lungs and/or air passages or for the healing of wounds in such parts of the body.
For larger scale applications, a suitable device may be used to disperse the ORP water solution into the air including, but not limited to, humidifiers, misters, foggers, vaporizers, atomizers, water sprays, and other spray devices. Such devices permit the dispensing of the ORP water solution on a continuous basis. An ejector which directly mixes air and water in a nozzle may be employed. The ORP water solution may be converted to steam, such as low pressure steam, and released into the air stream. Various types of humidifiers may be used such as ultrasonic humidifiers, stream humidifiers or vaporizers, and evaporative humidifiers. The particular device used to disperse the ORP water solution may be incorporated into a ventilation system to provide for widespread application of the ORP water solution throughout an entire house or healthcare facility (e.g., hospital, nursing home, etc.).
The ORP water solution administered in accordance with the present invention also can be used as the irrigation solution for negative pressure devices that are used to reduce edema and increase the blood flow. Suitable negative pressure devices can include, e.g., one or more vacuum assisted wound closure devices such as, e.g., the V.A.C.® and V.A.C.® InstillTM devices sold in the United States by Kinetic Concepts, Inc. It is believed that the ORP water solution can act synergistically with the device by controlling the inflammatory-allergic process while reducing the microbial load. Thus the device may be applied to the open abdominal cavity with intermittent or continuous irrigation to treat or prevent peritonitis (or abscesses or adhesions) in accordance with the present invention.
The ORP water solution administered in accordance with the present invention also can be used as the irrigation solution for hydrosurgery devices that are used to debride wounds. Suitable hydrosurgery devices can include, e.g., the VersaJet devices sold in the United States by Smith and Nephew, Debritom in Europe by Medaxis, JetOx in the United States and Europe by DeRoyal or PulsaVac in Italy. It is believed that the ORP water solution can act synergistically with the device by reducing the microbial load in the wound and by avoiding the formation of infectious mists during the debridement procedure. Thus the device can be used to debride the wounds with continuous irrigation, reduce the infection process and avoid the formation of infectious mists in accordance with the present invention.
In accordance with the present invention, a therapeutically effective amount of the ORP water solution can be administered alone or in combination with one or more additional therapeutic agents so as to treat or prevent peritonitis or so as to prevent the formation of adhesions or abscesses and to treat or prevent SIRS or multi-organ failure associated therewith For example, the ORP water solution can be administered in conjunction with one or more additional therapeutic agents, e.g., one or more compounds selected from the group consisting of anti-infective agents (e.g., anti-bacterial agents (such as, e.g., antibiotics), anti-fungal agents and anti-viral agents), anti-inflammatory agents, recombinant proteins or antibodies, one or more synthetic drugs and combinations thereof. Administering such therapeutic agents in conjunction with the ORP water solution can include administering one or more of such additional agents, e.g., prior to, during (e.g., contemporaneously, by co-administration or in combination with), or following administration of the ORP water solution.
Suitable antibiotics can include, without limitation, penicillin, cephalosporins or other β-lactams, macrolides (e.g., erythromycin, 6-O-methylerythromycin, and azithromycin), fluoroquinolones, sulfonamides, tetracyclines, aminoglycosides, clindamycin, quinolones, metronidazole, vancomycin, chloramphenicol, antibacterially effective derivatives thereof, and combinations thereof. Suitable anti-infective agents also can include antifungal agents such as, for example, amphotericin B, fluconazole, flucytosine, ketoconazole, miconazole, derivatives thereof, and combinations thereof. Suitable anti-inflammatory agents can include, e.g., one or more anti-inflammatory drugs, e.g., one or more anti-inflammatory steroids or one or more non-steroidal anti-inflammatory drugs (NSAIDs). Exemplary anti-inflammatory drugs can include, e.g., cyclophilins, FK binding proteins, anti-cytokine antibodies (e.g. anti-TNF), steroids, and NSAIDs.
In accordance with the invention, the ORP water solution can be administered alone or in combination with one or more pharmaceutically acceptable carriers, e.g., vehicles, adjuvants, excipients, diluents, combinations thereof, and the like, which are preferably compatible with one or more of the species that exist in the ORP water solution. One skilled in the art can easily determine the appropriate formulation and method for administering the ORP water solution used in accordance with the present invention. For instance, the use of a gel based formulation containing the ORP water solution can be used to maintain hydration of the peritoneal cavity while providing a barrier against microorganisms. Suitable gel formulations are described, e.g., in U.S. Patent Application Publication No. US 2005/0142157 (hereby incorporated by reference). Any necessary adjustments in dose can be readily made by a skilled practitioner to address the nature and/or severity of the condition being treated in view of one or more clinically relevant factors, such as, e.g., side effects, changes in the patient's overall condition, and the like.
For example, the ORP water solution can be formulated by combining or diluting the ORP water solution with about 25% (wt./wt. or vol./vol.) of a suitable carrier, about 50% (wt./wt. or vol./vol.) of a suitable carrier, about 75% (wt./wt. or vol./vol.) of a suitable carrier, about 90% (wt./wt. or vol./vol.) of a suitable carrier, about 95% (wt./wt. or vol./vol.) of a suitable carrier, or even with about 99% (wt./wt. or vol./vol.) or more of a suitable carrier. Suitable carriers can include, e.g., water (e.g., distilled water, sterile water, e.g., sterile water for injection, sterile saline and the like). Suitable carriers also can include one or more carriers described in U.S. patent application Ser. No. 10/916,278 (hereby incorporated by reference). Exemplary formulations can include, e.g., solutions in which the ORP water solution is diluted with sterile water or sterile saline, wherein the ORP water solution is diluted by about 25% (vol./vol.), by about 50% (vol./vol.), by about 75% (vol./vol.), by about 90% (vol./vol.), by about 95% (vol./vol.), or by 99% (vol./vol.) or more, depending on the therapeutic application and/or any other therapeutically relevant factors.
The ORP water solution administered in accordance with the invention can further be formulated in combination with one or more additional therapeutic agents, e.g., one or more active compounds selected from the group consisting of antibacterial agents (e.g., antibiotics), anti-viral agents, anti-inflammatory agents, and combinations thereof, as described herein.
The therapeutically effective amount administered to the patient, e.g., a mammal, particularly a human, in the context of the present invention should be sufficient to affect a therapeutic or prophylactic response in the patient over a reasonable time frame. The dose can be readily determined using methods that are well known in the art. One skilled in the art will recognize that the specific dosage level for any particular patient will depend upon a variety of potentially therapeutically relevant factors. For example, the dose can be determined based on the strength of the particular ORP water solution employed, the severity of the condition, the body weight of the patient, the age of the patient, the physical and mental condition of the patient, general health, sex, diet, and the like. The size of the dose also can be determined based on the existence, nature, and extent of any adverse side effects that might accompany the administration of a particular ORP water solution. It is desirable, whenever possible, to keep adverse side effects to a minimum.
Factors, which can be taken into account for a specific dosage can include, for example, bioavailability, metabolic profile, time of administration, route of administration, rate of excretion, the pharmacodynamics associated with a particular ORP water solution in a particular patient, and the like. Other factors can include, e.g., the potency or effectiveness of the ORP water solution with respect to the particular condition to be treated, the severity of the symptoms presented prior to, during or following the course of therapy, and the like. In some instances, what constitutes a therapeutically effective amount also can be determined, in part, by the use of one or more of the assays, e.g., bioassays, which are reasonably clinically predictive of the efficacy of a particular ORP water solution for the treatment or prevention of a particular condition.
The ORP water solution used in accordance with the present invention can be administered, alone or in combination with one or more additional therapeutic agents, to a patient, e.g., a human, e.g., to treat an existing condition. The ORP water solution of the present invention also can be administered prophylactically, alone or in combination with one or more additional therapeutic agents, to a patient, e.g., a human, that is at risk for developing the condition, e.g., from having been exposed to one or more causative agents associated with the condition. For example, the ORP water solution of the invention can be suitably administered to a patient that has been exposed to one or more inflammation-causing microorganisms (e.g., infections, viruses, bacteria and/or fungi) prophylactically to decrease the likelihood or severity of peritonitis, adhesions, abscesses, SIRS, multi-organ failure, and even infection, associated with the microorganism in a patient. The ORP water solution also can be used to continuously irrigate the surgical field,—including the peritoneum, gut, abdominal wall, and the like—during very long surgeries or when a mesh or another prosthesis is to be applied. In doing so, the possibility of contamination or infection can be reduced by taking advantage of the disinfecting properties of the ORP water solution, while continuously irrigating with the ORP water solution can further help to maintain proper hydration of the tissues. The frequency and the volume to be applied under these circumstances can be variable depending, e.g., on the nature of the surgery, condition of the patient, etc.
One skilled in the art will appreciate that suitable methods of administering the ORP water solution used in accordance with the present invention are available, and, although more than one route of administration can be used, one particular route may provide a more immediate and more effective reaction than another route. The therapeutically effective amount can be the dose necessary to achieve an “effective level” of the ORP water solution in an individual patient. The therapeutically effective amount can be defined, for example, as the amount required to be administered to an individual patient to achieve a blood level, tissue level, and/or intracellular level of the ORP water solution (or one or more active species contained therein) to prevent or treat the condition in the patient.
When the effective level is used as a preferred endpoint for dosing, the actual dose and schedule can vary depending, for example, upon interindividual differences in pharmacokinetics, distribution, metabolism, and the like. The effective level also can vary when the ORP water solution is used in combination with one or more additional therapeutic agents, e.g., one or more anti-infective agents, one or more “moderating,” “modulating” or “neutralizing agents,” e.g., as described in U.S. Pat. Nos. 5,334,383 and 5,622,848 (hereby incorporated by reference), one or more anti-inflammatory agents, and the like.
An appropriate indicator can be used for determining and/or monitoring the effective level. For example, the effective level can be determined by direct analysis (e.g., physical examination, analytical chemistry) or by indirect analysis (e.g., with clinical chemistry indicators) of appropriate patient samples (e.g., peritoneal fluid, blood and/or tissues). The effective level also can be determined, for example, by direct or indirect observations such as, e.g., the concentration of urinary metabolites, changes in markers associated with the condition (e.g., viral count in the case of a viral infection), histopathology and immunochemistry analysis, decreases in the symptoms associated with the condition, and the like.
Conventional ORP water solutions have an extremely limited shelf-life, usually only a few hours. As a result of this short lifespan, using conventional ORP water solutions requires the production to take place in close proximity to the point of use. From a practical standpoint, this means that the facility, e.g., a healthcare facility such as a hospital, must purchase, house and maintain the equipment necessary to produce conventional ORP water solution. Additionally, conventional manufacturing techniques have not been able to produce sufficient commercial-scale quantities to permit widespread use, e.g., as a general disinfecting agent for healthcare facilities.
Unlike conventional ORP water solutions, the ORP water solution administered in accordance with the invention is stable for at least about twenty-hours after its preparation. In addition, the ORP water solution administered in accordance with the invention is generally environmentally safe and, thus, avoids the need for costly disposal procedures.
Preferably, the ORP water solution administered in accordance with the invention is stable for at least about one week (e.g., one week, two weeks, three weeks, four weeks, etc.), and more preferably at least about two months. Still more preferably, the ORP water solution administered in accordance with the invention is stable for at least about six months. Even more preferably, the ORP water solution administered in accordance with the invention is stable for at least about one year, and most preferably is stable for more than about one year, e.g., at least about two years or at least about three years.
Stability can be measured based on the ability of the ORP water solution to remain suitable for one or more uses, for example, inhibiting mast cell degranulation, inhibiting cytokine secretion, decontamination, disinfection, sterilization, anti-microbial cleansing, and wound cleansing, for a specified period of time after its preparation under normal storage conditions (e.g., room temperature). The stability of the ORP water solution administered in accordance with the invention also can be measured by storage under accelerated conditions, e.g., from about 30° C. to about 60° C., wherein the ORP water solution preferably is stable for up to about 90 days, and more preferably for up to about 180 days.
Stability also can be measured based on the concentration over time of one or more species (or precursors thereof) present in solution during the shelf-life of the ORP water solution. Preferably, the concentrations of one or more species, e.g., free chlorine, hypochlorous acid and one or more superoxidized water species and are maintained at about 70% or greater of their initial concentration for at least about two months after preparation of the ORP water solution. More preferably, the concentration of one of more of these species is maintained at about 80% or greater of their initial concentration for at least about two months after preparation of the ORP water solution. Still more preferably, the concentration of one or more of such species is maintained at about 90% or greater, and most preferably is maintained at about 95% or greater, of their initial concentration for at least about two months after preparation of the ORP water solution.
Stability also can be determined based on the reduction in the amount of organisms present in a sample following exposure to the ORP water solution. Measuring the reduction of organism concentration can be made on the basis of any suitable organism including, e.g., bacteria, fungi, yeasts, or viruses. Suitable organisms can include, e.g., Escherichia coli, Staphylococcus aureus, Candida albicans, and Bacillus athrophaeus (formerly B. subtilis).
Stability also can be determined based on the reduction in the amount of endotoxins (e.g. lipopolysacharides), growth factors, cytokines and other proteins and lipids present in a sample following exposure to the ORP water solution.
The ORP water solution administered in accordance with the invention can function as a low-level disinfectant capable of a four log (104) reduction in the concentration of live microorganisms, and also can function as a high-level disinfectant capable of a six log (106) reduction in concentration of live microorganisms. Preferably, the ORP water solution administered in accordance with the invention is capable of yielding at least about a four log (104) reduction in total organism concentration, following exposure for one minute when measured at least about two months after preparation of the solution. More preferably, the ORP water solution is capable of a 104-106 reduction of organism concentration when measured at least about six months after preparation of the solution. Still more preferably, the ORP water solution is capable of a 104-106 reduction of organism concentration when measured at least about one year after preparation of the ORP water solution, and most preferably when measured more than about one year, e.g., at least about two years or at least about three years, after preparation of the ORP water solution.
For instance, the ORP water solution is capable of at least about five log (105) reduction in the concentration of a sample of live microorganism selected from the group consisting of Pseudomonas aeruginosa, Escherichia coli, Enterococcus hirae, Acinetobacter baumannii, Acinetobacter species, Bacteroides fragilis, Enterobacter aerogenes, Enterococcus faecalis, Vancomycin Resistant-Enterococcus faecium (VRE, MDR), Haemophilus influenzae, Klebsiella oxytoca, Klebsiella pneumoniae, Micrococcus luteus, Proteus mirabilis, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus, Streptococcus pneumoniae, Streptococcus pyogenes, Candida albicans and Candida tropicalis, within 30 seconds of exposure, when measured at least two months after preparation of the ORP water solution.
In one embodiment, the ORP water solution administered in accordance with the invention can reduce a sample of live microorganisms including, but not limited to, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Candida albicans, from an initial concentration of between about 1×106 and about 1×108 organisms/ml to a final concentration of about zero organisms/ml within about one minute of exposure when measured at least about two months after preparation of the ORP water solution. This corresponds to from about a six log (106) to about an eight log (108) reduction in organism concentration. Preferably, the ORP water solution is capable of achieving a 106-108 reduction of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus or Candida albicans organisms when measured at least about six months after preparation, and more preferably when measured at least about one year after preparation.
Alternatively, the ORP water solution administered in accordance with the present invention can produce about a six log (106) reduction in the concentration of a spore suspension of Bacillus athrophaeus spores within about five minutes of exposure when measured at least about two months after preparation of the ORP water solution. Preferably, the ORP water solution administered in accordance with the invention can achieve about a 106 reduction in the concentration of Bacillus athrophaeus spores when measured at least about six months after preparation, and more preferably when measured at least about one year after preparation.
The ORP water solution administered in accordance with the invention also can produce about a four log (104) reduction in the concentration of a spore suspension of Bacillus athrophaeus spores within about thirty (30) seconds of exposure when measured at least about two months after preparation of the ORP water solution. Preferably, the ORP water solution can achieve this reduction in the concentration of Bacillus athrophaeus spores when measured at least about six months after preparation, and more preferably when measured, at least about one year after preparation.
The ORP water solution administered in accordance with the invention further can produce about a six log (106) reduction in the concentration of fungal spores, such as Aspergillis niger spores, within about five to about ten minutes of exposure when measured at least about two months after preparation of the ORP water solution. Preferably, the ORP water solution can achieve a 106 reduction in the concentration of fungal spores when measured at least about six months after preparation, and more preferably when measured at least about one year after preparation.
Alternatively, the ORP water solution administered in accordance with the invention preferably can yield at least about a 106 reduction in the concentration of a sample of live microorganisms selected from the group consisting of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, C. perfingens, Neisseria gonorrhea, Chlamydia trachomatis, streptococci, enteroococci, and Candida albicans, and combinations thereof, within about one minute of exposure when measured at least about two months after preparation of the solution.
The ORP water solution administered in accordance with the invention further can produce more than 3 log (103) reduction in the concentration of viruses, such as Human Immunedeficiency Virus (HIV) and adenovirus, within about five to about ten minutes of exposure when measured at least about two months after preparation of the ORP water solution. Preferably, the ORP water solution can achieve a >103 reduction in the concentration of viruses when measured at least about six months after preparation, and more preferably when measured at least about one year after preparation.
The ORP water solution administered in accordance with the invention further can completely inhibit the growth of Mycobacterium bovis within about five minutes of exposure when measured at least about two months after preparation of the ORP water solution. Preferably, the ORP water solution can achieve the total inhibition in the concentration of Mycobacteria when measured at least about six months after preparation, and more preferably when measured at least about one year after preparation.
The ORP water solution administered in accordance with the invention can be acidic, neutral or basic, and generally can have a pH of from about 1 to about 14. Within this pH range, the ORP water solution can be safely applied in suitable quantities, e.g., to surfaces without damaging the surfaces or harming objects, such as human skin, that comes into contact with the ORP water solution. Preferably, the pH of the ORP water solution administered in accordance with the invention is from about 3 to about 8. More preferably, the pH of the ORP water solution is from about 6.4 to about 7.8, and still more preferably, the pH is from about 7.4 to about 7.6.
The ORP water solution administered in accordance with the invention can have an oxidation-reduction potential of from about −1000 millivolts (mV) to about +1150 millivolts (mV). This potential is a measure of the tendency (i.e., the potential) of a solution to either accept or transfer electrons that are sensed by a metal electrode and compared with a reference electrode in the same solution. This potential may be measured by standard techniques including, for example, measuring the electrical potential in millivolts of the ORP water solution relative to standard reference such as, e.g., a silver/silver chloride electrode.
The ORP water solution administered in accordance with the invention preferably has a potential of from about −400 mV to about +1300 mV. More preferably, the ORP water solution has a potential of from about 0 mV to about +1250 mV, and still more preferably from about +500 mV to about +1250 mV. Even more preferably, the ORP water solution administered in accordance with the present invention has a potential of from about +800 mV to about +1100 mV, and most preferably from about +800 mV to about +1000 mV.
Various ionic and other species may be present in the ORP water solution administered in accordance with the invention. For example, the ORP water solution may contain chlorine (e.g., free chlorine and bound chlorine), one or more additional superoxidized water species (e.g., one or more oxygen species, e.g., dissolved oxygen) and, optionally, ozone and peroxides (e.g., hydrogen peroxide). The presence of one or more of these species is believed to contribute to at least the disinfectant ability of the ORP water solution to kill a variety of microorganisms, such as bacteria and fungi, as well as viruses. Although not wishing to be bound by any particular theory, it is believed that or more of such species also may contribute to the efficacy of the ORP water solution in treating or preventing peritonitis, and/or in preventing hemorrhage and the formation of adhesions or abscess associated therewith. The inhibition of the synthesis and secretion of cytokines could yet be other effects of the ORP water solution.
Free chlorine typically includes, but is not limited to, hypochlorous acid (HClO), hypochlorite ions (ClO−) and sodium hypochlorite (NaOCl), and precursors thereof. The ratio of hypochlorous acid to hypochlorite ion is dependent upon pH. At a pH of 7.4, hypochlorous acid levels are typically from about 25 ppm to about 75 ppm. Temperature also impacts the ratio of the free chlorine component.
Bound chlorine typically includes chlorine in chemical combination with, e.g., ammonia or organic amines (e.g., chloramines). Bound chlorine is preferably present in an amount of up to about 20 ppm.
One or more chlorine species, one or more additional superoxidized water species (e.g., one or more oxygen species), oxygen, and can be present in the ORP water solution in any suitable amount. The levels of these components may be measured by any suitable method, including methods known in the art.
The total chlorine content, which includes both free chlorine and, optionally, bound chlorine, can be from about 10 parts per million (ppm) to about 400 ppm, e.g., from about 10 parts ppm to about 200 ppm, from about 20 ppm to about 150 ppm, from about 30 ppm to about 100 ppm, from about 30 to about 80 ppm, or, e.g., from about 50 ppm to about 200 ppm or from about 80 ppm to about 150 ppm.
The chlorine content may be measured by methods known in the art, such as the DPD colorimeter method (Lamotte Company, Chestertown, Md.) or other known methods such as, e.g., methods established by the Environmental Protection Agency. In the DPD colorimeter method, a yellow color is formed by the reaction of free chlorine with N,N-diethyl-p-phenylenediamine (DPD) and the intensity is measured with a calibrated calorimeter that provides the output in parts per million. Further addition of potassium iodide turns the solution a pink color to provide the total chlorine value. The amount of bound chlorine present is then determined by subtracting free chlorine from the total chlorine.
The total amount of oxidizing chemical species present in the ORP water solution is preferably in the range of about 2 millimolar (mM), may include the aforementioned chlorine species, oxygen species, and additional species, including those, which can be difficult to measure such as, e.g., Cl−, ClO3, Cl2−, and ClOx.
In one embodiment, the ORP water solution of the invention comprises one or more chlorine species and one or more additional superoxidized water species (e.g., one or more additional oxidizing species such as, e.g., oxygen). Preferably, the chlorine species present as a free chlorine species. The free chlorine species can include one or more species selected from the group consisting of hypochlorous acid (HOCl), hypochlorite ions (OCl−), sodium hypochlorite (NaOCl),), chloride ion (Cl−), and, optionally, and dissolved chlorine gas (Cl2), precursors thereof and mixtures thereof.
The total amount of free chlorine species is preferably from about 10 ppm to about 400 ppm, more preferably from about 50 ppm to about 200 ppm, and most preferably from about 50 ppm to about 80 ppm. The amount of hypochlorous acid is preferably from about 15 ppm to about 35 ppm. The amount of sodium hypochlorite is preferably in the range of from about 25 ppm to about 50 ppm. Chlorine dioxide levels are preferably less than about 5 ppm.
In one embodiment, the ORP water solution includes one or more chlorine species or one or more precursors thereof, one or more additional superoxidized water species (e.g., one or more oxygen species), and, optionally, hydrogen peroxide, and is stable for at least about 24 hours, preferably for at least about one week, more preferably for at least about two months, and still more preferably for at least about six months after its preparation. Even more preferably, such ORP water solution is stable for at least about one year, and most preferably for more than about one year, e.g., at least about two years or at least about three years.
It is also preferred that the ORP water solution includes one or more chlorine species (e.g., hyprochlorous acid and sodium hypochlorite) or one or more precursors thereof and one or more additional oxidizing species (e.g., oxygen) or one or more precursors thereof and has a pH of from about 6 to about 8, more preferably from about 6.2 to about 7.8, and most preferably from about 7.4 to about 7.6. An exemplary ORP water solution administered in accordance with the present invention can comprise, e.g., from about 15 ppm to about 35 ppm hypochlorous acid, from about 25 ppm to about 50 ppm sodium hypochlorite, from about 1 ppm to about 4 ppm of one or more additional superoxidized water species and a pH of from about 6.2 to about 7.8, and can be stable for at least about one week, e.g., at least about two months, at least about six months, at least about one year, or more than about one year, e.g., at least about two years or at least about three years.
While in no way limiting the present invention, it is believed that the control of pH and other variables (e.g., salinity) can provide stable ORP water solutions, which contain one or more chlorine species or precursors thereof, such as, e.g., hypochlorous acid and hypochlorite ions, and one or more superoxidized water species (e.g., oxygen).
The ORP water solutions administered in accordance with the invention preferably comprises one or more oxidized water species which can yield free radicals (such as, e.g., hydroxyl radicals) on exposure to iron. The ORP water can optionally include one or more chemical compounds generated during the production thereof such as, e.g., sodium hydroxide (NaOH), chlorine dioxide (ClO2), peroxides (e.g., hydrogen peroxide (H2O2), and ozone (O3) although, it has been reported that sodium hydroxide, chlorine dioxide, hydrogen peroxide, and ozone may react with hypocholrite resulting in their consumption and the production of other chemical species.
The ORP water solution administered in accordance with the present invention can be produced by an oxidation-reduction process, e.g., by an electrolytic process or redox reaction, in which electrical energy is used to produce one or more chemical changes in an aqueous solution. Exemplary processes for preparing suitable ORP water solutions are described, e.g., in U.S. Patent Application Publication Nos. US 2005/0139808 and US 2005/0142157 (hereby incorporated by reference).
In the electrolytic process, electrical energy is introduced into and transported through water by the conduction of electrical charge from one point to another in the form of an electrical current. In order for the electrical current to arise and subsist there should be charge carriers in the water, and there should be a force that makes the carriers move. The charge carriers can be electrons, as in the case of metal and semiconductors, or they can be positive and negative ions in the case of solutions. A reduction reaction occurs at the cathode while an oxidation reaction occurs at the anode. At least some of the reductive and oxidative reactions that are believed to occur are described in International Application WO 03/048421 A1.
As used herein, water produced at an anode is referred to as anode water and water produced at a cathode is referred to as cathode water. Anode water typically contains oxidized species produced from the electrolytic reaction while cathode water typically contains reduced species from the reaction. Anode water generally has a low pH, typically of from about 1 to about 6.8. The anode water preferably contains chlorine in various forms including, for example, chlorine gas, chloride ions, hydrochloric acid and/or hypochlorous acid, or one or more precursors thereof. Oxygen in various forms is also preferably present including, for example, oxygen gas, and possibly one or more species formed during production (e.g., peroxides and/or ozone), or one or more precursors thereof. Cathode water generally has a high pH, typically from about 7.2 to about 11. Cathode water can contain hydrogen gas, hydroxyl radicals, and/or sodium ions.
The ORP water solution administered in accordance with the invention can include a mixture of anode water (e.g., water produced in the anode chamber of an electrolytic cell) and cathode water (e.g., water produced in the cathode chamber of an electrolysis cell). Preferably, the ORP water solution administered in accordance with the present invention contains cathode water, e.g., in an amount of from about 10% by volume to about 90% by volume of the solution. More preferably, cathode water is present in the ORP water solution in an amount of from about 10% by volume to about 50% by volume, and still more preferably of from about 20% by volume to about 40% by volume of the solution, e.g., from about 20% by volume to about 30% by volume of the solution. Additionally, anode water can be present in the ORP water solution, e.g., in an amount of from about 50% by volume to about 90% by volume of the solution. Exemplary ORP water solutions can contain from about 10% by volume to about 50% by volume of cathode water and from about 50% by volume to about 90% by volume of anode water. The anode and cathode water can be produced using the three-chambered electrolysis cell shown in FIG. 1.
The ORP water solution administered in accordance with the invention is preferably produced using at least one electrolysis cell comprising an anode chamber, a cathode chamber and a salt solution chamber located between the anode and cathode chambers, wherein at least some of the anode and cathode water are combined such that the ORP water solution comprises anode water and cathode water. A diagram of an exemplary three chamber electrolysis cell that can be used in preparing an exemplary ORP water solution is shown in FIG. 2.
The electrolysis cell 100 has an anode chamber 102, cathode chamber 104 and salt solution chamber 106. The salt solution chamber is located between the anode chamber 102 and cathode chamber 104. The anode chamber 102 has an inlet 108 and outlet 110 to permit the flow of water through the anode chamber 100. The cathode chamber 104 similarly has an inlet 112 and outlet 114 to permit the flow of water through the cathode chamber 104. The salt solution chamber 106 has an inlet 116 and outlet 118. The electrolysis cell 100 preferably includes a housing to hold all of the components together.
The anode chamber 102 is separated from the salt solution chamber by an anode electrode 120 and an anion ion exchange membrane 122. The anode electrode 120 may be positioned adjacent to the anode chamber 102 with the membrane 122 located between the anode electrode 120 and the salt solution chamber 106. Alternatively, the membrane 122 may be positioned adjacent to the anode chamber 102 with the anode electrode 120 located between the membrane 122 and the salt solution chamber 106.
The cathode chamber 104 is separated from the salt solution chamber by a cathode electrode 124 and a cathode ion exchange membrane 126. The cathode electrode 124 may be positioned adjacent to the cathode chamber 104 with the membrane 126 located between the cathode electrode 124 and the salt solution chamber 106. Alternatively, the membrane 126 may be positioned adjacent to the cathode chamber 104 with the cathode electrode 124 located between the membrane 126 and the salt solution chamber 106.
The electrodes preferably are constructed of metal to permit a voltage potential to be applied between the anode chamber and cathode chamber. The metal electrodes are generally planar and have similar dimensions and cross-sectional surface area to that of the ion exchange membranes. The electrodes are configured to expose a substantial portion of the surface of the ion exchange members to the water in their respective anode chamber and cathode chamber. This permits the migration of ionic species between the salt solution chamber, anode chamber and cathode chamber. Preferably, the electrodes have a plurality of passages or apertures evenly spaced across the surface of the electrodes.
A source of electrical potential is connected to the anode electrode 120 and cathode electrode 124 so as to induce an oxidation reaction in the anode chamber 102 and a reduction reaction in the cathode chamber 104.
The ion exchange membranes 122 and 126 used in the electrolysis cell 100 may be constructed of any suitable material to permit the exchange of ions between the salt solution chamber 106 and the anode chamber 102 such as, e.g., chloride ions (Cl−) and between the salt solution salt solution chamber 106 and the cathode chamber 104 such as, e.g., sodium ions (Na+). The anode ion exchange membrane 122 and cathode ion exchange membrane 126 may be made of the same or different material of construction. Preferably, the anode ion exchange membrane comprises a fluorinated polymer. Suitable fluorinated polymers include, for example, perfluorosulfonic acid polymers and copolymers such as perfluorosulfonic acid/PTFE copolymers and perfluorosulfonic acid/TFE copolymers. The ion exchange membrane may be constructed of a single layer of material or multiple layers. Suitable ion exchange membrane polymers can include one or more ion exchange membrane polymers marketed under the trademark Nafion®.
The source of the water for the anode chamber 102 and cathode chamber 104 of the electrolysis cell 100 may be any suitable water supply. The water may be from a municipal water supply or alternatively pretreated prior to use in the electrolysis cell. Preferably, the water is pretreated and is selected from the group consisting of softened water, purified water, distilled water, and deionized water. More preferably, the pretreated water source is ultrapure water obtained using reverse osmosis and UV light purification equipment.
The salt water solution for use in the salt water chamber 106 can include any aqueous salt solution that contains suitable ionic species to produce the ORP water solution. Preferably, the salt water solution is an aqueous sodium chloride (NaCl) salt solution, also commonly referred to as a saline solution. Other suitable salt solutions can include other chloride salts such as potassium chloride, ammonium chloride and magnesium chloride as well as other halogen salts such as potassium and bromine salts. The salt solution can contain a mixture of salts.
The salt solution can have any suitable concentration. For example, the salt solution can be saturated or concentrated. Preferably, but not exclusively, the salt solution is a saturated sodium chloride solution.
FIG. 2 illustrates what are believed to be various ionic species produced in the three chambered electrolysis cell useful in connection with the invention. The three chambered electrolysis cell 200 includes an anode chamber 202, cathode chamber 204, and a salt solution chamber 206. Upon application of a suitable electrical current to the anode 208 and cathode 210, the ions present in the salt solution flowing through the salt solution chamber 206 migrate through the anode ion exchange membrane 212 and cathode ion exchange membrane 214 into the water flowing through the anode chamber 202 and cathode chamber 204, respectively.
Positive ions migrate from the salt solution 216 flowing through the salt solution chamber 206 to the cathode water 218 flowing through the cathode chamber 204. Negative ions migrate from the salt solution 216 flowing through the salt solution chamber 206 to the anode water 220 flowing through the anode chamber 202.
Preferably, the salt solution 216 is aqueous sodium chloride (NaCl), which contains both sodium ions (Na+) and chloride ions (Cl−) ions. Positive Na+ ions migrate from the salt solution 216 to the cathode water 218. Negative Cl− ions migrate from the salt solution 216 to the anode water 220.
The sodium ions and chloride ions may undergo further reaction in the anode chamber 202 and cathode chamber 204. For example, chloride ions can react with various oxygen ions and other species (e.g., oxygen containing free radicals, O2, O3) present in the anode water 220 to produce ClOn- and ClO−. Other reactions may also take place in the anode chamber 202 including the formation of oxygen free radicals, hydrogen ions (H+), oxygen (e.g., as O2), ozone (O3), and peroxides. In the cathode chamber 204, hydrogen gas (H2), sodium hydroxide (NaOH), hydroxide ions (OH−), and other radicals may be formed.
The apparatus for producing the ORP water solution also can be constructed to include at least two three-chambered electrolysis cells. Each of the electrolytic cells includes an anode chamber, cathode chamber, and salt solution chamber separating the anode and cathode chambers. The apparatus includes a mixing tank for collecting the anode water produced by the electrolytic cells and a portion of the cathode water produced by one or more of the electrolytic cells. Preferably, the apparatus further includes a salt recirculation system to permit recycling of the salt solution supplied to the salt solution chambers of the electrolytic cells. A diagram of an exemplary process for producing an ORP water solution using two electrolysis cells is shown in FIG. 3.
The process 300 includes two three-chambered electrolytic cells, specifically a first electrolytic cell 302 and second electrolytic cell 304. Water is transferred, pumped or otherwise dispensed from the water source 305 to anode chamber 306 and cathode chamber 308 of the first electrolytic cell 302 and to anode chamber 310 and cathode chamber 312 of the second electrolytic cell 304. Advantageously, this process can produce from about 1 liter/minute to about 50 liters/minute of ORP water solution. The production capacity may be increased by using additional electrolytic cells. For example, three, four, five, six, seven, eight, nine, ten or more three-chambered electrolytic cells may be used to increase the output of the ORP water solution administered in accordance with the invention.
The anode water produced in the anode chamber 306 and anode chamber 310 are collected in the mixing tank 314. A portion of the cathode water produced in the cathode chamber 308 and cathode chamber 312 is collected in mixing tank 314 and combined with the anode water. The remaining portion of cathode water produced in the process is discarded. The cathode water may optionally be subjected to gas separator 316 and/or gas separator 318 prior to addition to the mixing tank 314. The gas separators remove gases such as hydrogen gas that are formed in cathode water during the production process.
The mixing tank 314 may optionally be connected to a recirculation pump 315 to permit homogenous mixing of the anode water and portion of cathode water from electrolysis cells 302 and 304. Further, the mixing tank 314 may optionally include suitable devices for monitoring the level and pH of the ORP water solution. The ORP water solution may be transferred from the mixing tank 314 via pump 317 for application in disinfection or sterilization at or near the location of the mixing tank. Alternatively, the ORP water solution may be dispensed into one or more suitable containers, e.g., for shipment to a remote site (e.g., warehouse, hospital, etc.).
The process 300 further includes a salt solution recirculation system to provide the salt solution to salt solution chamber 322 of the first electrolytic cell 302 and the salt solution chamber 324 of the second electrolytic cell 304. The salt solution is prepared in the salt tank 320. The salt is transferred via pump 321 to the salt solution chambers 322 and 324. Preferably, the salt solution flows in series through salt solution chamber 322 first followed by salt solution chamber 324. Alternatively, the salt solution may be pumped to both salt solution chambers simultaneously.
Before returning to the salt tank 320, the salt solution may flow through a heat exchanger 326 in the mixing tank 314 to control the temperature of the ORP water solution as needed.
The ions present in the salt solution are depleted over time in the first electrolytic cell 302 and second electrolytic cell 304. An additional source of ions periodically can be added to the mixing tank 320 to replace the ions that are transferred to the anode water and cathode water. The additional source of ions may be used, e.g., to maintain a constant pH of the salt solution, which can to drop (i.e., become acidic) over time. The source of additional ions may be any suitable compound including, for example, salts such as, e.g., sodium chloride. Preferably, sodium hydroxide is added to the mixing tank 320 to replace the sodium ions (Na+) that are transferred to the anode water and cathode water.
Following its preparation, the ORP water solution can be transferred to one or more suitable containers, e.g., a sealed container for distribution and sale to end users such as, e.g., health care facilities including, e.g., hospitals, nursing homes, doctor offices, outpatient surgical centers, dental offices, and the like. Suitable containers can include, e.g., a sealed container that maintains the sterility and stability of the ORP water solution held by the container. The container can be constructed of any material that is compatible with the ORP water solution. Preferably, the container is generally non-reactive with one or more ions or other species present in the ORP water solution.
Preferably, the container is constructed of plastic or glass. The plastic can be rigid so that the container is capable of being stored on a shelf. Alternatively, the container can be flexible, e.g., a container made of flexible plastic such as, e.g., a flexible bag. Suitable plastics can include, e.g., polypropylene, polyester terephthalate (PET), polyolefin, cycloolefin, polycarbonate, ABS resin, polyethylene, polyvinyl chloride, and mixtures thereof. Preferably, the container comprises one or more polyethylenes selected from the group consisting of high-density polyethylene (HDPE), low-density polyethylene (LDPE), and linear low-density polyethylene (LLDPE). Most preferably, the container is constructed of high density polyethylene.
The container preferably has an opening to permit dispensing of the ORP water solution. The container opening can be sealed in any suitable manner. For example, the container can be sealed with a twist-off cap or stopper. Optionally, the opening can be further sealed with a foil layer.
The ORP water solution to be used in the abdominal cavity and retroperitoneum can be formulated and bottled at the production facility or readily prepared prior to application, e.g., by mixing the stock with water, saline solution or any other compatible aqueous solution.
The headspace gas of the sealed container can be air or any other suitable gas, which preferably does not react with one or more species in the ORP water solution. Suitable headspace gases can include, e.g., nitrogen, oxygen, and mixtures thereof.
The ORP water solution administered in accordance with the invention also can be used for the prevention or treatment of an infection, e.g., by one or more infectious pathogens such as, for example, infectious microorganisms. Such microorganisms can include, for example, viruses, bacteria, and fungi. The viruses can include, e.g., one or more viruses selected from the group consisting of adenoviruses, herpes viruses, coxsackie viruses, HIV, rhinoviruses, comaviruses, and flu viruses. The bacteria can include, e.g., one or more bacteria selected from the group consisting of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Mycobaterium tuberculosis. The fungi can include, e.g., one or more fungi selected from the group consisting of Candida albicans, Bacillus subtilis and Bacillus athrophaeus. 
The ORP water solution administered in accordance with the invention also can be effective against adenovirus. Preferably, the ORP water solution administered in accordance with the invention preferably achieves a log-10 reduction in the adenoviral load of greater than about 3, after exposure to the ORP water solution for about 20 minutes, more preferably after exposure for about 15 minutes, and still more preferably after exposure for about 5 minutes. The ORP water solution administered in accordance with the invention also can be effective for reducing the viral load of HIV-1, preferably by a log reduction factor greater than about 2, more preferably by a log reduction factor of greater than about 2.5, and still more preferably by a log reduction factor of greater than about 3 after exposure to the ORP water solution for about five minutes.
In accordance with the method of the present invention, administering the ORP water solution for the prevention or treatment of infection also can serve to prevent or treat peritonitis associated with the infection (or the affected tissues) as described herein.
The ORP water solution administered in accordance with the invention also can be used for treating impaired or damaged tissue, e.g., by contacting one or more impaired or damaged tissues with a therapeutically effective amount of the ORP water solution. Any suitable method can be used for contacting the impaired or damaged tissue, so as to treat the impaired or damaged tissue. For example, the impaired or damaged tissue can be treated by irrigating the tissue with the ORP water solution, so as to contact the impaired or damaged tissue with a therapeutically effective amount of the ORP water solution. The ORP water solution can be administered as a steam or a spray, or by aerosolization, nebulization or atomization, or through a negative or positive pressure device or a hydrosurgery device, as described herein, so as to contact the impaired or damaged tissue with a therapeutically effective amount of the ORP water solution.
The ORP water solution administered in accordance with the invention can be used for treating tissues, which have been impaired or damaged, e.g., by surgery. For instance, the ORP water solution can be used for treating tissues, which have been impaired or damaged by an incision. In addition, the ORP water solution can be used for treating tissues, which have been impaired or damaged by graft surgery, implant surgery, transplant surgery, cauterization, amputation, radiation, chemotherapy, and combinations thereof. If desired, the ORP water solution can be used for treating tissues, which have been impaired or damaged by oral surgery, e.g., dental surgery such as, e.g., root canal surgery, tooth extraction, gum surgery, and the like.
It is possible that the high oxygen content and other oxidizing species in the ORP water administered in accordance with the invention (e.g., one or more active oxygen species and one or more chlorine species) can exert positive healing properties such as, e.g., the chemotaxis of fibroblasts and the formation of a new extracellular matrix.
The ORP water solution administered in accordance with the invention can be used for treating tissues, which have been impaired or damaged by one or more burns, cuts, abrasions, scrapes, rashes, ulcers, puncture wounds, combinations thereof, and the like, which are not necessarily caused by surgery. The ORP water solution administered in accordance with the invention can be used for treating impaired or damaged tissue, which is infected, or tissue impaired or damaged due to infection. Such infection can be caused by one or more infectious pathogens, such as, e.g., one or more microorganisms selected from the group consisting of viruses, bacteria, and fungi, as described herein.
In accordance with the present invention, administering the ORP water solution for treating impaired or damaged tissue also can serve to prevent or treat peritonitis associated with the impairment or damage (or with the impaired or damaged tissue).
The ORP water solution administered in accordance with the invention also can be used as a disinfectant to eradicate microorganisms, including bacteria, viruses and spores, in a variety of settings, e.g., in the healthcare and medical device fields, to disinfect surfaces and medical equipment, and also have been applied in wound care, medical device sterilization, food sterilization, hand disinfection in medical personnel, hospitals, consumer households and anti-bioterrorism. The ORP water solution can be used for disinfecting a surface, e.g., by contacting the surface with an anti-infective amount of the ORP water solution. The surface can be contacted using any suitable method. For example, the surface can be contacted by irrigating the surface with the ORP water solution, so as to disinfect the surface. Additionally, the surface can be contacted by applying the ORP water solution to the surface as a steam or a spray, or by aerosolization, nebulization or atomization or positive pressure devices, as described herein, so as to disinfect the surface. Further, the ORP water solution can be applied to the surface with a cleaning wipe, as described herein. By disinfecting a surface, the surface may be cleansed of infectious microorganisms. Alternatively (or additionally), the ORP water solution administered in accordance with the present invention can be applied to the surface to provide a barrier to infection, to thereby disinfect the surface. The ORP water solution also can be used to disinfect or maintain sterility of the instruments throughout long surgeries.
The surface(s) can include one or more biological surfaces, one or more inanimate surfaces, and combinations thereof. Biological surfaces can include, for example, tissues within one or more body cavities such as, for example, the oral cavity, the sinus cavity, the cranial cavity, the abdominal/peritoneal cavity, and the thoracic cavity. The biological tissue also can include tissues within the oral cavity include, e.g., mouth tissue, gum tissue, tongue tissue, and throat tissue. The biological tissue also can include muscle tissue, bone tissue, organ tissue, mucosal tissue, vascular tissue, neurological tissue, and combinations thereof. Inanimate surfaces include, for example, surgically implantable devices, prosthetic devices, and medical devices. In accordance with the method of the present invention, the surfaces of internal organs, viscera, muscle, and the like, which may be exposed during surgery, can be disinfected, e.g., to maintain sterility of the surgical environment. Administering the ORP water solution for disinfecting a surface also can serve to treat or prevent peritonitis by preventing an infection by one or more susceptible microorganisms that can reside on such surfaces.
The ORP water solution may also be applied to humans and/or animals to treat various conditions, including but not limited to peritonitis associated with one or more of the following: surgical/open wound cleansing agent; skin pathogen disinfection (e.g., for bacteria, mycoplasmas, virus, fungi, prions); battle wound disinfection; wound healing promotion; burn healing promotion; treatment of stomach ulcers; wound irrigation; and other conditions such as e.g., skin fungi; psoriasis; athlete's foot; pinkeye and other eye infections; ear infections (e.g., swimmer's ear); lung/nasal/sinus infections; and other medical applications on or in the human or animal body. The use of ORP water solutions as a tissue cell growth promoter is further described in U.S. Patent Application Publication 2002/0160053 (hereby incorporated by reference).
The ORP water solution used in accordance with the invention has a wide variety of environmental uses as a disinfectant, cleanser, cleaner, antiseptic and the like to control the activity of unwanted or harmful substances present in the environment. Substances that may be treated with the ORP water solution include, for example, organisms and allergens.
Other applications can include the following: medical, dental and/or veterinary equipment and devices; food industry (e.g., hard surfaces, fruits, vegetables, meats); ambient remediation in hospitals/health care facilities (e.g., hard surfaces); cosmetic industry (e.g., skin cleaner); households (e.g., floors, counters, hard surfaces); electronics industry (e.g., cleaning circuitry, hard drives); and bio-terrorism (e.g., anthrax, infectious microbes).
Organisms that can be controlled, reduced, killed or eradicated by treatment with the ORP water solution used in accordance with the invention include, e.g., Pseudomonas aeruginosa, Escherichia coli, Enterococcus hirae, Acinetobacter baumannii, Acinetobacter species, Bacteroides fragilis, Enterobacter aerogenes, Enterococcus faecalis, Vancomycin resistant-Enterococcus faecium (VRE, MDR), Haemophilus influenzae, Klebsiella oxytoca, Klebsiella pneumoniae, Micrococcus luteus, Proteus mirabilis, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus, Streptococcus pneumoniae, Streptococcus pyogenes, Salmonella choleraesuis, Shigella dysenteriae, and other susceptible bacteria, as well as yeasts, e.g., Trichophyton mentagrophytes, Candida albicans and Candida tropicalis. The ORP water solution can also be applied in accordance with the invention to control, reduce, kill or eradicate viruses including, e.g., adenovirus, human immunodeficiency virus (HIV), rhinovirus, influenza (e.g., influenza A), hepatitis (e.g., hepatitis A), coronavirus (responsible for Severe Acute Respiratory Syndrome (SARS)), rotavirus, respiratory syncytial virus, herpes simplex virus, varicella zoster virus, rubella virus, and other susceptible viruses.
The ORP water solution used in accordance with the invention also can be used in controlling the activity of allergens present in the environment. In this context, allergens typically include any substance other than bacteria, fungi, yeasts, or viruses that can trigger an adverse immune response, or allergy, in susceptible people or animals. Asthma is a common physiological response following exposure to one or more of such allergens. Allergens can be either viable (i.e., from living or dead organisms) or non-viable (e.g., non-living such as textiles), and may be present in the environment, for example, in households and/or workplaces.
Protein-based household allergens that may be treated with the ORP water solution can include, for example, animal fur, skin, and feces, household dust, weeds, grasses, trees, mites, and pollens. Animal allergens can include, for example, cat epithelium, dog epithelium, horse dander, cow dander, dog dander, guinea pig epithelium, goose feathers, mouse epithelium, mouse urine, rat epithelium and rat urine.
Occupational allergens can include, for example, high-molecular-weight agents, such as natural proteins generally derived from plant or animal proteins, and low-molecular-weight chemicals, such as diisocyanates, and other material found in some textiles. Other chemical allergens that may be present in the workplace can include, for example, anhydrides, antibiotics, wood dust and dyes. Numerous proteins may be occupational allergens including vegetable gums, enzymes, animal proteins, insects, plant proteins, and legumes.
Additional allergens that can be treated by the ORP water solution are described in Korenblat and Wedner, Allergy Theory and Practice (1992) and Middleton, Jr., Allergy Principles and Practice (1993).
The ORP water solution may be applied to disinfect and sterilize in any suitable manner. For example, to disinfect and sterilize medical or dental equipment, the equipment can be maintained in contact with the ORP water solution for a sufficient period of time to reduce the level of organisms present on the equipment to a desired level.
For disinfection and sterilization of hard surfaces, the ORP water solution can be applied to the hard surface directly from a container in which the ORP water solution is stored. For example, the ORP water solution can be poured, sprayed or otherwise directly applied to the hard surface. The ORP water solution can then be distributed over the hard surface using a suitable substrate such as, for example, cloth, fabric or paper towel. In hospital applications, the substrate is preferably sterile. Alternatively, the ORP water solution can first be applied to a substrate such as cloth, fabric or paper towel. The wetted substrate can then be contacted with the hard surface. Alternatively, the ORP water solution can be applied to hard surfaces by dispersing the solution into the air as described herein. The ORP water solution can be applied in a similar manner to humans and animals.
The ORP water solution also can be applied with a cleaning wipe comprising a water insoluble substrate and the ORP water solution described herein, wherein the ORP water solution is dispensed onto the substrate. The ORP water solution can be impregnated, coated, covered or otherwise applied to the substrate. Preferably, the substrate is pretreated with the ORP water solution before distribution of the cleaning wipes to end users.
The substrate for the cleaning wipe can be any suitable water-insoluble absorbent or adsorbent material. A wide variety of materials can be used as the substrate. It should have sufficient wet strength, abrasivity, loft and porosity. Further, the substrate should not adversely impact the stability of the ORP water solution. Examples include non woven substrates, woven substrates, hydroentangled substrates and sponges.
The substrate can have one or more layers. Each layer can have the same or different textures and abrasiveness. Differing textures can result from the use of different combinations of materials or from the use of different manufacturing processes or a combination thereof. The substrate should not dissolve or break apart in water. The substrate can thereby provide a vehicle for delivering the ORP water solution to the surface to be treated.
The substrate can be a single nonwoven sheet or multiple nonwoven sheets. The nonwoven sheet can be made of wood pulp, synthetic fibers, natural fibers, and blends thereof. Suitable synthetic fibers for use in the substrate can include, without limitation, polyester, rayon, nylon, polypropylene, polyethylene, other cellulose polymers, and mixtures of such fibers. The nonwovens can include nonwoven fibrous sheet materials which include meltblown, coform, air-laid, spun bond, wet laid, bonded-carded web materials, hydroentangled (also known as spunlaced) materials, and combinations thereof. These materials can comprise synthetic or natural fibers or combinations thereof. A binder can optionally be present in the substrate.
Examples of suitable nonwoven, water insoluble substrates include 100% cellulose Wadding Grade 1804 from Little Rapids Corporation, 100% polypropylene needlepunch material NB 701-2.8-W/R from American Non-wovens Corporation, a blend of cellulosic and synthetic fibres-Hydraspun 8579 from Ahlstrom Fibre Composites, and 70% Viscose/30% PES Code 9881 from PGI Nonwovens Polymer Corp. Additional examples of nonwoven substrates suitable for use in the cleaning wipes are described in U.S. Pat. Nos. 4,781,974, 4,615,937, 4,666,621, and 5,908,707, and International Patent Application Publications WO 98/03713, WO 97/40814, and WO 96/14835 (hereby incorporated by reference).
The substrate also can be made of woven materials, such as cotton fibers, cotton/nylon blends, or other textiles. Regenerated cellulose, polyurethane foams, and the like, which are used in making sponges, also can be suitable for use.
The liquid loading capacity of the substrate should be at least about 50%-1000% of the dry weight thereof, most preferably at least about 200%-800%. This is expressed as loading 1⁄2 to 10 times the weight of the substrate. The weight of the substrate varies without limitation from about 0.01 to about 1,000 grams per square meter, most preferably 25 to 120 grams/m2 (referred to as “basis weight”) and typically is produced as a sheet or web which is cut, die-cut, or otherwise sized into the appropriate shape and size. The cleaning wipes will preferably have a certain wet tensile strength which is without limitation about 25 to about 250 Newtons/m, more preferably about 75-170 Newtons/m.
The ORP water solution can be dispensed, impregnated, coated, covered or otherwise applied to the substrate by any suitable method. For example, individual portions of substrate can be treated with a discrete amount of the ORP water solution. Preferably, a mass treatment of a continuous web of substrate material with the ORP water solution is carried out. The entire web of substrate material can be soaked in the ORP water solution. Alternatively, as the substrate web is spooled, or even during creation of a nonwoven substrate, the ORP water solution can be sprayed or metered onto the web. A stack of individually cut and sized portions of substrate can be impregnated or coated with the ORP water solution in its container by the manufacturer.
The cleaning wipes optionally can contain additional components to improve the properties of the wipes. For example, the cleaning wipes can further comprise polymers, surfactants, polysaccharides, polycarboxylates, polyvinyl alcohols, solvents, chelating agents, buffers, thickeners, dyes, colorants, fragrances, and mixtures thereof to improve the properties of the wipes. These optional components should not adversely impact the stability of the ORP water solution. Examples of various components that may optionally be included in the cleaning wipes are described in U.S. Pat. Nos. 6,340,663, 6,649,584 and 6,624,135 (hereby incorporated by reference).
The cleaning wipes of the invention can be individually sealed with a heat-sealable or glueable thermoplastic overwrap (such as polyethylene, Mylar, and the like). The wipes can also be packaged as numerous, individual sheets for more economical dispensing. The cleaning wipes can be prepared by first placing multiple sheets of the substrate in a dispenser and then contacting the substrate sheets with the ORP water solution of the invention. Alternatively, the cleaning wipes can be formed as a continuous web by applying the ORP water solution to the substrate during the manufacturing process and then loading the wetted substrate into a dispenser.
The dispenser includes, but is not limited to, a canister with a closure, or a tub with closure. The closure on the dispenser is to seal the moist wipes from the external environment and to prevent premature volatilization of the liquid ingredients.
The dispenser can be made of any suitable material that is compatible with both the substrate and the ORP water solution. For example, the dispenser can be made of plastic, such as high density polyethylene, polypropylene, polycarbonate, polyethylene terephthalate (PET), polyvinyl chloride (PVC), or other rigid plastics.
The continuous web of wipes can be threaded through a thin opening in the top of the dispenser, most preferably, through the closure. A means of sizing the desired length or size of the wipe from the web can then be desirable. A knife blade, serrated edge, or other means of cutting the web to desired size can be provided on the top of the dispenser, for non-limiting example, with the thin opening actually doubling in duty as a cutting edge. Alternatively, the continuous web of wipes can be scored, folded, segmented, perforated or partially cut into uniform or non-uniform sizes or lengths, which would then obviate the need for a sharp cutting edge. Further, the wipes can be interleaved, so that the removal of one wipe advances the next.
The ORP water solution of the invention alternatively can be dispersed into the environment through a gaseous medium, such as air. The ORP water solution can be dispersed into the air by any suitable means. For example, the ORP water solution can be formed into droplets of any suitable size and dispersed into a room.
For small scale applications, the ORP water solution can be dispensed through a spray bottle that includes a standpipe and pump. Alternatively, the ORP water solution can be packaged in aerosol containers. Aerosol containers can include the product to be dispensed, propellant, container, and valve. The valve can include both an actuator and dip tube. The contents of the container can be dispensed by pressing down on the actuator. The various components of the aerosol container should be compatible with the ORP water solution. Suitable propellants can include a liquefied halocarbon, hydrocarbon, or halocarbon-hydrocarbon blend, or a compressed gas such as carbon dioxide, nitrogen, or nitrous oxide. Aerosol systems preferably yield droplets that range in size from about 0.15 μm about 5 μm.
The ORP water solution administered in accordance with the invention optionally can contain additives suitable, e.g., for the household and workplace cleaning environment. Suitable additives can include, e.g., surfactants, such as detergents and cleaning agents. Perfumes or other scent-producing compounds also can be included to enhance consumer reception of the ORP water solution. Alternatively, a marker dye may be added to facilitate evaluation of the particular application.
For some applications, the ORP water solution optionally can contain a bleaching agent. The bleaching agent can include, e.g., a compound that lightens or whitens a substrate. The ORP water solution containing a bleaching agent can be used in home laundering to disinfect and sterilize bacteria and germs as well as brighten clothing. Suitable bleaching agents include, but are not limited to, chlorine-containing bleaching agents and peroxide-containing bleaching agents. Mixtures of bleaching agents also can be added to the ORP water solution. The bleaching agent can be added in the form of an aqueous solution to the ORP water solution.
Suitable chlorine-containing bleaching agents can include, e.g., chlorine, hypochlorites, N-chloro compounds, and chlorine dioxide. Preferably, the chlorine-containing bleaching agent added to the ORP water solution is sodium hypochlorite or hypochlorous acid. Other suitable chlorine-containing bleaching agents include, e.g., chlorine, calcium hypochlorite, bleach liquor (e.g., aqueous solution of calcium hypochlorite and calcium chloride), bleaching powder (e.g., mixture of calcium hypochlorite, calcium hydroxide, calcium chloride, and hydrates thereof), dibasic magnesium hypochlorite, lithium hypochlorite, chlorinated trisodium phosphate and mixtures thereof.
The addition of a bleaching agent to the ORP water solution can be carried out in any suitable manner. For instance, an aqueous solution containing a bleaching agent can be prepared using household bleach (e.g., Clorox® bleach) or other suitable source of chlorine-containing bleaching agent or other bleaching agent. The bleaching agent solution can then be combined with the ORP water solution.
The bleaching agent can be added to the ORP water solution in any suitable amount. Preferably, the ORP water solution containing a bleaching agent is non-irritating to human or animal skin. The total chloride ion content of the ORP water solution containing a chlorine-containing bleaching agent can be from about 1000 ppm to about 5000 ppm, e.g., from about 1000 ppm to about 3000 ppm. The pH of the ORP water solution containing a chlorine-containing bleaching agent is preferably from about 8 to about 10, and the oxidative-reductive potential of the solution is preferably from about +700 mV to about +800 mV.
The following examples further illustrate the invention but, of course, should not rued as in any way limiting in its scope.
Examples 1-3
These examples demonstrate the unique features of the ORP water solution used in accordance with the invention. The samples of the ORP water solution in Examples 1-3 were analyzed in accordance with the methods described herein to determine the physical properties and levels of ionic and other chemical species present in each sample. Results obtained for chlorine dioxide, ozone and hydrogen peroxide are based on standard tests used to measure such species but may be indicative of different species, which can also generate positive test results. Further, it has been reported that chlorine dioxide, ozone and hydrogen peroxide react with hypocholrite resulting in their consumption and the production of other compounds (e.g., HCl and O2.) The pH, oxidative-reductive potential (ORP) and ionic species present are set forth in Table 1 for each sample of the ORP water solution.







TABLE 1







Physical characteristics and ion species present


for the ORP water solution samples











EXAMPLE 1
EXAMPLE 2
EXAMPLE 3













pH
7.45
7.44
7.45


ORP (mV)
+879
+881
+874


Total Cl− (ppm)
110
110
120


Bound Cl− (ppm)
5
6
6









The ORP water solution has suitable physical characteristics for use in, e.g., disinfection, sterilization, cleaning, and/or the prevention and/or treatment of inflammation, sinusitis, peritonitis, or infection.
Examples 4-10
These examples demonstrate the addition of a bleaching agent to the ORP water solution according to the invention in various amounts. In particular, these examples demonstrate the antimicrobial activity and fabric bleaching ability of the compositions.
A 10% Clorox® bleach solution was prepared using distilled water. The following solutions were then prepared using the 10% bleach solution: 80% ORP water solution/20% bleach (Example 4); 60% ORP water solution/40% bleach (Example 5); 40% ORP water solution/60% bleach (Example 6); 20% ORP water solution/80% bleach (Example 7); and 0% ORP water solution/100% bleach (Example 8). Two control solutions were also used for comparison including 100% ORP water solution/0% bleach (Example 9) and an ORP water solution with 0.01% Tween 20 detergent (Example 10). The physical characteristics of these samples were determined, specifically pH, oxidative-reductive potential (ORP), total chlorine (Cl−) content, and hypochlorous acid (HClO) content, and were tested for chlorine dioxide content and peroxide content, the results of which are set forth in Table 2.







TABLE 2







Physical characteristics of ORP water


solution/bleach compositions














Total Cl−
HClO



pH
ORP
(ppm)
(ppm)
















Ex. 4
8.92
+789
1248
62



Ex. 5
9.20
+782
2610
104 



Ex. 6
9.69
+743
4006
80



Ex. 7
9.86
+730
4800
48



Ex. 8
9.80
+737
5000
50



Ex. 9
7.06
+901
 64
32



Ex. 10
6.86
+914
 51
26









The large bolus of chlorine ions added as part of the bleaching agent prevented the accurate measurement of the chlorine dioxide and peroxide levels. Also, results obtained for chlorine dioxide and peroxide are based on standard tests used to measure such species but may be indicative of different species, which can also generate positive test results. Further, it has been reported that chlorine dioxide, ozone and hydrogen peroxide react with hypochlorite resulting in their consumption and the production of other compounds (e.g., HCl and O2). As these examples demonstrate, the hypochlorous acid levels of the ORP water solution with and without the addition of a bleaching agent are similar.
The samples of Examples 4-10 were subjected to a high spore count test using Bacillus subtilis var. niger spores (ATCC #9372 obtained from SPS Medical of Rush, N.Y.). Spore suspensions were concentrated (by evaporation in a sterile hood) to 4×106 spores per 100 microliters. A 100 microliter sample of the spore suspension were mixed with 900 microliters of each of the samples in Examples 4-10. The samples were incubated at room temperature for periods of 1 to 5 minutes as set forth in Table 3. At the indicated times, 100 microliters of the incubated samples were plated onto individual TSA plates and incubated for 24 hours at 35° C.±2° C., after which the number of resulting colonies on each plate was determined. The control plates demonstrated that the starting spore concentrations were >1×106 spores/100 microliters. The concentration of Bacillus spores for the various samples at the various incubation times (as the average of two determinations) is set forth in Table 3.







TABLE 3







Bacillus spore concentrations













1 minute
2 minutes
3 minutes
4 minutes
5 minutes















Ex. 4
>>1000
411
1
0
2


Ex. 5
>>1000
1000
1
0
0


Ex. 6
>>1000
>>1000
>1000
22
0


Ex. 7
>>1000
>>1000
>1000
15
0


Ex. 8
>>1000
>>1000
>1000
3
1


Ex. 9
>>1000
74
0
0
0


Ex. 10
>>1000
239
3
0
0









As these results demonstrate, as the concentration of bleach (as 10% aqueous bleach solution) increases, the amount of Bacillus spores killed is reduced for the samples incubated for 2-3 minutes. However, for samples incubated for 5 minutes, the bleach concentration does not impact Bacillus spore kill. Further, the results demonstrate that the addition of 0.01% detergent to the ORP water solution does not reduce spore kill.
The samples of Examples 4-10 were subjected to a fabric bleaching test. The fabric upon which the samples were tested was a 100% rayon children's t-shirt with dark blue dye patches. Two inch square pieces of dyed fabric were placed into 50 mL plastic tubes. Each fabric piece was covered by a sample of the solution in Examples 4-10. The elapsed time until complete bleaching was obtained, as determined by the whitening of the fabric, is set forth in Table 4.







TABLE 4







Time until complete bleaching of fabric sample










Example
Time














Ex. 4
39
minutes



Ex. 5
23
minutes



Ex. 6
18
minutes



Ex. 7
19
minutes



Ex. 8
10
minutes



Ex. 9
>6
hours



Ex. 10
>6
hours









As demonstrated by these examples, as the concentration of the ORP water solution increases in the composition, the time until complete bleaching is achieved increases.
Example 11
The purpose of this study was to assess the safety of the test an exemplary ORP water solution, Microcyn, when administered as drops into the nasal cavity of rabbits. Thirty-three rabbits were randomly assigned to two groups, Groups I and II. Group I (18 animals) served as the control group and Group II (15 animals) was dosed with the test article. On Day −1 or Day 0, body weights were recorded and blood samples were, collected for analysis of selected parameters. On Day 0, 500 μL of sterile saline was administered to the Group I animals and 500 μL of the test article (at a 50% concentration) was administered to Group n annuals. Both the control and the test articles were administered twice daily as drops into the right nostril. The animals were dosed in the same manner on Days 1-6. Animals were observed daily for signs of pharmacologic and/or toxicologic effects with special attention paid to the nose. Body weights were recorded weekly through study termination. On Day 7, one-third of the animals from each group were selected for blood collection, sacrifice and necropsy. The remaining animals continued to be dosed through Day 14, when half of the animals from each group were selected for blood collection, sacrifice and necropsy. On Day 21, after a 7-day recovery period), the remaining animals had blood collected and were sacrificed and necropsied. Samples of the nasal mucosa from both nostrils were collected from each animal for histopathological analysis.
The necropsy consisted of gross observations of the respiratory tract. The entire nasal passage and associated bone were taken and fixed in buffered formalin. Samples of any visible abnormalities in the respiratory tract were also collected for histopathology. Three biopsy samples (anterior, middle and posterior nasal cavity) per nostril (treated right and untreated left) were examined. The microscopic histopathology of the nasal mucosa included: integrity of epithelium, presence or loss of epithelial cilia, inflammatory cell infiltration, edema, presence of goblet cells, hyperplasia of glands, changes in number or characteristics of blood vessels and any other changes or observations.
The results (in-life observations including nasal observations, body weights, blood analysis, gross necropsy and histopathology results) from the test group were compared to the control group. The test group was not significantly different from animals treated with saline in terms of mild irritation.
Example 12
This example demonstrates the lack of toxicity and stability of ORP water solutions.
Toxicological studies were carried in which Microcyn 60 was applied topically to the intact skin, using a single application with exposure of 4 to 24 h. Multiple applications of Microcyn 60, one or two times a day, during a period of 7 days were assessed for deep wounds in rats.
Two studies were carried out on the intact skin of rabbits to evaluate the effect of Microcyn 60 as to acute irritation and dermal toxicity. No clinical signs, dermal irritation, or abnormalities in the skin at autopsy were found in any of the animals exposed to Microcyn 60.
The characterization of local and systemic toxicity from topically applied Microcyn 60 to a deep wound was evaluated in rats. No abnormalities, significant differences in the parameters of the blood chemistry or hematic cytology were observed, nor anomalies in the autopsies. The skin irritation gradings and the histopathology of the wounds and the tissues around the place of application did not reveal any difference between the wounds treated with Microcyn 60 and those of the control group treated with saline solution.
The systemic toxicity of Microcyn 60 was also evaluated by means of an intraperitoneal injection in mice. For this, five mice were injected with a single dose (50 mL/kg) of Microcyn 60 by the intraperitoneal route. In the same way, five control mice were injected with a single dose (50 mL/kg) of saline solution (sodium chloride at 0.9%). In this investigation, neither mortality nor any evidence of systemic toxicity was observed in any of the animals that received the single intraperitoneal dose of Microcyn 60, indicating that the LD50 is above 50 mL/kg.
Microcyn 60 was administered by the oral route to rats to allow its absorption and to characterize any inherent toxic effect of the product. In this study, a single dose (4.98 mL/kg) was administered by esophageal tube to three albino rats of the Sprague-Dawley strain. There was no mortality, nor were there clinical signs or abnormalities in the autopsies of any of the animals exposed to the single oral dose of Microcyn 60.
The potential of topically applied Microcyn 60 for ocular irritation was also evaluated in rabbits. Ocular irritation was not observed nor any other clinical sign in any animal exposed to Microcyn 60 by topical administration through the ocular route.
Microcyn 60 was applied by the inhalatory route to rats to determine potential acute toxicity by inhalation. All the animals showed a very slight or slight reduction in activity and piloerection after the exposure, but they were all asymptomatic on the following day. Mortality or abnormalities were not observed at autopsy of the animals exposed to Microcyn 60 by inhalation.
Evaluation of the potential for sensitization of the skin with Microcyn 60 was carried out in guinea pigs using a modified occlusion patch method (Buehler). Irritation was not observed in the animals of the control group after a simple treatment challenge, nor in the animals evaluated (treated by induction) after challenge with the treatment. These studies demonstrate that Microcyn 60 does not provoke a sensitizing reaction.
Thus, when it has been applied to the intact skin, deep open dermal wounds, in the conjunctival sac, by oral and inhalation routes or by means of intraperitoneal injection, Microcyn 60 has not shown adverse effects related to the product. There is also experience in having treated thousands of patients with wounds of very diverse nature in the skin and mucosae, with excellent antiseptic and cosmetic results. Accordingly, topically applied Microcyn 60 should be effective and well-tolerated in humans.
Microcyn 60 is packaged in transparent 240 mL PET sealed bottles. This product is stored at ambient temperature and remains stable for up to 2 years in such bottles. From its profile of high biological safety, Microcyn 60 can be safely disposed of, e.g., emptied into the sink without risk of contamination or corrosion.
Multiple microbial trials have been run with Microcyn 60, both in the United States and in Mexico. Eradication of more than 90% of the bacteria occurs in the first few seconds of exposure. The antibacterial and antimycotic activity that Microcyn 60 exhibits in accordance with this standard is summarized in Table 5.







TABLE 5







Kill times.













Time of action



Bacterium
Catalog
(reduction below 99.999%)







Ps. Aeruginosa
ATCC 25619
1 min



St. aureus
ATCC 6538
1 min



E. coli
ATCC 11229
1 min



S. typhi
CDC 99
1 min



C. albicans
ATCC
1 min



B. subtilis
9372




Low spore (104)

10 min 



High spore (106)

15 min 










The sporicidal activity trial was carried out in accordance with the PAHO [Pan-American Health Organization]/WHO protocol.
The virucidal activity of Microcyn 60 has been confirmed in studies carried out in the United States against HIV and its activity against Listeria monocytogenes, methicillin-resistant Staphylococcus aureus (MRSA), and Mycobacterium bovis has also been demonstrated. Thus, it has been demonstrated that Microcyn 60, when it is administered as recommended, can eradicate bacteria, fungi, viruses and spores from one to fifteen minutes of exposure.
Example 13
This example demonstrates the viricidal activity of an exemplary ORP water solution against Adenovirus-serotype 5. For this example Adenoviral (Ad) vectors based on human adenovirus type 5 which are E1a-, partially E1-b, and partially E3-deleted were used. A shuttle plasmid containing the Green Fluorescent Protein (GFP) reporter gene under the transcriptional control of pCMV was prepared (pAd-Track). Homologous recombination of this pShuttle plasmid with AdEasy 1 plasmid was carried out in electrocompetent bacteria. Clones that had inserts were tested by restriction endonuclease digestions. Once confirmed, supercoiled plasmid DNA was transformed into DH10B cells for large scale amplification. Subsequently, 293 cells (ATCC 1573) were cultured in serum-free medium (OptiMEM-GIBCO) and transfected with recombinant plasmid digested with Pad. Infected cells were monitored for cytopathic effect, collected and lysed with three cycles of freezing and thawing. The resultant viruses (AdGFP) were purified with AdenoPure columns (BD Clontech) according to the manufacturer's instructions. Viruses were quantitated by OD 260/280. Final yield was 1.52×1011 pfu/mL.
The efficacy of the ORP water solution for inactivating adenovirus encoding the green fluorescence protein gene (AdGFP), was evaluated using a test based on the detection of fluorescence emission from HeLa cells infected with either, control AdGFP viruses or ORP water solution-treated AdGFP, using fluorescence-activated flow cytometry. Infection of HeLa cells was always carried out with 7.5×107 pfu/mL (i.e. 150 m.o.i.). In all test conditions, cells appeared normal under light microscopy. The background fluorescence measured in control HeLa cells was 0.06%. After infection with control AdGFP, 88.51% of HeLa cells expressed GFP. Following exposure to the ORP water solution, adenovirus infectivity decreased inversely proportionally to the exposure period. Accordingly, ORP water solution-treated virus for 1, 5, and 10 min could only express GFP in 2.8%, 0.13%, and 0.09% of HeLa cell cultures, respectively. Considering the autofluorescence and the initial viral load for all tested conditions (i.e. 7.5×107 pfu), the infectious titer was 6.6×107 pfu in the control AdGFP-HeLa group. In the groups where the virus had been treated with the ORP water solution, the infectious titers were 2.0×106, 5.2×104 and 2.2×104 at one, five and ten minutes of virus exposure to the ORP water solution, respectively. Therefore, the log-10 reduction factor was 1.5, 3.1, and 3.5 at one, five and ten minutes of viral exposure to the ORP water solution. Taken together, these results demonstrate that the virus exposure to the ORP water solution for 5 minutes achieves a log-10 reduction in the viral load of >3.
Example 14
This example demonstrates the virucidal effectiveness of an exemplary ORP water solution against HIV using the United States Environmental Protection Agency protocol for disinfection of inanimate environmental surfaces.
The SF33 strain of HIV-1 was used for this study. Peripheral blood mononuclear cells from healthy donors were activated with PHA (3 μg/mL, Sigma) and human IL-2 (20 U/mL, Roche) in HUT media for three days. Cells were washed and infected with SF33 strain. Supernatant was collected on days 4 and 6, and tested for the p24 HIV-1 antigen by ELISA (Beckman Coulter). Supernatant was centrifuged to remove cell and debris at 3000 RPM for 20 min at room temperature. Supernatant was removed, aliquoted, and the virus was stored at −80° C. until the day of use.
Frozen aliquots were thawed at 37° C. for two minutes immediately prior to its use. Serial logarithmic dilutions (−1 to −5) in HUT medium were used. Films of virus were prepared by spreading 0.2 ml of virus inoculum uniformly over the bottoms of 55 cm2 sterile polystyrene Petri dishes. The virus films were air-dried at room temperature (21° C.) in a biological safety cabinet until they looked visibly dry (20 minutes). (To assure that the virus strain (SF33) was capable of replicating and causing cytopathic effects, the procedure was repeated with a viral suspension that had remained in HUT medium without being dried.)
The control film was exposed to 2 ml HUT media for five minutes. The virus was then scraped and diluted. Separate dried films were exposed to 2 ml each of the ORP water solution for five minutes at room temperature. Following the exposure time, the plates were scraped and their contents were resuspended. The virus-ORP water solution mixture was immediately diluted (10:1) in HUT medium. Serial log dilutions of this resulting suspension were assayed for infectivity. (To control for a possible direct cytotoxic effect of ORP water solution on MT-2 cells, a 2 ml aliquot of ORP water solution was diluted serially (10:1 to 10:5) in medium and inoculated into MT-2 cell cultures.)
The MT-2 cell line was used as the indicator cell line in the infectivity assays. This line shows a cytopathic effect consisting of sincitia formation when infected with HIV-1. Four microwells were inoculated with 0.2 ml of each dilution of the reconstituted virus suspension from test (reconstituted in ORP water solution) and control (reconsituted with control medium) groups. Uninfected cell controls were inoculated with test medium only. Cultures were incubated at 37° C. and 5% CO2.
The cultures were scored periodically every two days for the presence or absence of cytopathic effect as well as presence of p24-HIV-1 antigen by ELISA. Experimental infection with control HIV-1 exerted a cytopathic effect and Ag p24 protein release into the supernatant in infected MT-2 cultures. In contrast, treatment of HIV-1 with the ORP water solution for five minutes, achieved a log reduction factor >3 in the viral load as measured in MT-2 cultures by both assays at 5 minutes of exposure. These results thus demonstrate the level of efficacy that is in conformity with the EPA requirements for HIV-1 virucidal activity on inanimate surfaces.
Example 15
This example demonstrates the effect of an exemplary ORP water solution versus hydrogen peroxide (HP) on the viability of human diploid fibroblasts (HDFs). To study this potential toxicity, HDFs were exposed in vitro to ORP water solution and hydrogen peroxide (HP). HP is known to be toxic to eukaryotic cells, increasing apoptosis and necrosis and reducing cellular viability. In this example, cell viability, apoptosis and necrosis were measured in HDFs exposed to pure ORP water solution and 880 mM HP (a concentration employed for antiseptic uses of HP) for 5 and 30 minutes.
HDF cultures were obtained from three different foreskins, which were pooled and cryopreserved together for the purpose of this study. Only diploid cells were used for all experiments. On cell cycle analysis, DNA diploidy was defined as the presence of a single G0-G1 peak with a CV</=7% and a corresponding G2/M peak collected from at least 20,000 total events. FIG. 4A-4C disclose the results where exposure times of 5 and 30 minutes are depicted in white and black bars, respectively. Simultaneous analyses of these parameters were performed in the same cell populations by flow cytometry using: A) 7-aminoactinomycin D (7AAD); B) Annexin V-FITC; and C) Propidium iodide. FIG. 4A-4C disclose percentage values expressed as mean±SD (n=3).
Cell viability was 75% and 55% after a 5 minute exposure to ORP water solution and HP, respectively (FIG. 4A). If the exposure was prolonged to 30 min, cell viability further decreased to 60% and 5%, respectively. Apparently, the ORP water solution induced cell death through necrosis because 15% of the cells incorporated propidium iodide in the flow cytometry analysis at both times (FIG. 4C). Apoptosis does not seem to be the mechanism by which the ORP water solution induces cell death because only 3% of ORP water solution-treated cells exposed Annexin-V in the cellular surface (a marker of apoptosis) (FIG. 4B). This percentage was actually similar to the one measured in the control group. On the contrary, HP induced necrosis in 20% and 75% of treated cells and apoptosis in 15% and 20% after 5 and 30 min of exposure, respectively. Altogether these results show that the (undiluted) ORP water solution is far less toxic for HDFs than an antiseptic concentration of HP.
Example 16
This example demonstrates the effect of an exemplary ORP water solution relative to hydrogen peroxide (HP) on oxidative DNA damage and formation of the DNA adduct 8-hydroxy-2′-deoxiguanosine (8-OHdG) in HDFs. It is known that the production of 8-OHdG adducts in a cell is a marker of oxidative damage at specific residues of DNA. In addition, high cellular levels of this adduct correlate with mutagenesis, carcinogenesis and cellular aging.
FIG. 5 shows the levels of 8-OHdG adducts present in DNA samples from HDFs after control treatments, ORP water solution treatments and HP-treatments for 30 minutes. DNA was extracted right after the exposure (TO, white bars) or three hours after the challenge period (T3, black bars). DNA was digested and the 8-OHdG adducts were measured by ELISA kit as per the manufacturer's instructions. Values are shown (ng/mL) as mean±SD (n=3). The exposure to ORP water solution for 30 minutes did not increase the formation of adducts in the treated cells in comparison to control cells after incubation for 30 minutes. In contrast, the treatment with 500 μM HP for 30 minutes increased the number of 8-OHdG adducts by about 25 fold relative to the control-treated or ORP water solution-treated cells.
The ORP water solution-treated cells were able to decrease the levels of 8-OHdG adducts if left in supplemented DMEM for 3 hours after exposure to the ORP water solution. Despite being allowed the same 3 hour recovery period, HP-treated cells still presented about 5 times more adducts than control-treated or ORP water solution treated cells. Altogether, these results demonstrate that acute exposure to the ORP water solution does not induce significant DNA oxidative damage. These results also indicate that the ORP water solution will not likely induce mutagenesis or carcinogenesis in vitro or in vivo.
Example 17
This example demonstrates the effects on HDFs of chronic exposure to low concentrations of an exemplary ORP water solution versus HP. It is known that chronic oxidative stress induces premature aging of cells. In order to mimic a prolonged oxidative stress, primary HDF cultures were chronically exposed to low concentrations of the ORP water solution (10%) or HP (5 μM) during 20 population doublings. The expression and activity of the SA-β-galactosidase enzyme has previously been associated with the senescence process in vivo and in vitro. In this example the expression of the SA-β-galactosidase enzyme was analyzed after one month of continuous exposure of HDF to the ORP water solution or HP. The results are depicted in FIG. 6. The expression of the enzyme SA-β-galactosidase was analyzed by counting the number of blue cells in 20 microscopic fields. (For an example staining pattern, see Panel A.) Panel B shows that only HP treatment accelerated the aging of cells as indicated by the number of cells over-expressing SA-β-galactosidase (n=3). Chronic treatment with a low dose of HP increased the SA-β-Gal expression in 86% of cells while the treatment with the ORP water solution did not induce the overexpression of this protein. It can be concluded from this example that ORP water solution is not an inducer of premature cellular aging.
Example 18
This example demonstrates the effect of an exemplary ORP water solution on the reduction of peritoneal bacterial load and on the reduction in the length of hospital stay in patients with peritonitis. All patients admitted to the Hospital Ruben Lenero in Mexico City from June 2004 to January 2005, and with a diagnosis of acute generalized, secondary peritonitis, were included in the ORP water solution-treated group. Secondary peritonitis was defined as the result of the loss of integrity of the gastrointestinal or genito-urinary tract leading to contamination of the peritoneal space. Retrospective analysis of paired-cases presenting similar peritoneal infections between 2003 and 2004 at the same Institution was undertaken for the control group. Twenty consecutive patients were prospectively included in the ORP water solution-treated group (i.e. study group).
Upon admission, all patients underwent open surgery and intra-operative peritoneal lavage (“IOPL”) of all quadrants of the abdomen. Intraoperative peritoneal-culture samples were taken in both groups. IOPL was performed with 10 L of saline solution in both groups and followed by 5 L of the ORP water solution in the study group only. The excess ORP water solution was removed and no further rinsing was conducted. The abdominal cavity was covered with a plastic mesh in both groups. However, in the study group, a dressing soaked in ORP water solution was left on top of the mesh. The dressing was changed t.i.d. Empiric antimicrobial therapy was started in all patients with two antibiotics including clindamycin and cefotaxime or amikacin. Post-operative management in the study group included daily irrigation of the mesh with 100 mL of the ORP water solution t.i.d., without further rinsing or lavage. Severe cases of peritonitis required re-laparotomy and IOPL every 72 hours. Cultures of the peritoneal fluid for aerobic bacteria and fungi were taken every 72 hours in both groups for up to one week. The duration of length of stay in the hospital was recorded.
Twenty control cases were selected from the medical records of the Institution and paired to the study group by age, sex and etiology of peritonitis. The control and study populations were comparable in age, sex and prognostic factors at entry. The anatomic origin and etiology of peritonitis was also similar for both groups (Table 6).







TABLE 6







Primary Diagnosis of Peritonitis Patients













DIAGNOSIS
CONTROL
STUDY
TOTAL
%
















Appendicitis
3
6
9
23.0



Post-trauma
1
3
4
10.0



Pancreatitis
6
3
9
23.0



Cholecystitis
1
2
3
7.5



Colon cancer
0
1
1
2.5



Small bowel
4
1
5
12.5



fistula







Diverticulitis
1
1
2
5.0



Gastric
4
0
4
10.0



perforation







Other Organ
0
2
2
5.0



perforation







Other
0
1
1
2.5



TOTAL
20
20
40
100.0









Post-operative peritonitis was present in 19 and 17 patients of the control and study groups, respectively. All cases underwent surgical treatment followed by IOPL. The types of surgeries performed in control/study groups, were: appendicectomy (3/6), gastric resection (4/0), cholecystectomy (1/2), pancreatic necrosectomy (6/3), small bowel suture/resection with anastomosis (4/3), Hartman's operation (1/1), colonic resection (0/1) and miscellaneous (1/4). The use of antibiotics was very similar in both groups. For control and study groups, three antibiotics were administered in 16 and 15 patients and more than 3 antibiotics in 4 and 5 cases, respectively. Patients were kept at the ICU and were mechanically ventilated post-operatively. Peri-operative intra-abdominal samples were taken in all 40 patients (Table 7).







TABLE 7







Microorganisms isolated from intraperitoneal samples


and length of hospital stay


in patients with peritonitis.










CONTROL GROUP
STUDY GROUP












Isolated strains

Isolated strains




(n)
Hospital
(n)
Hospital













Organism
Peri-op
Post-op
Days
Peri-op
Post-op
Days
















C. albicans
10
7
19.4
7
0
6.3


E. coli
3
2
17.6
6
1
10.2


S. aureus
10
9
22.3
8
1
14.1


coagulase
0
0
0
2
0
17.8


neg. Staph.








A. baumanii
0
0
0
1
0
22.4


E. faecalis
3
3
23.7
1
0
28.6


A.
0
0
0
1
0
28.6


xilosoxidans








P.
2
2
24.0
3
0
33.9


aeruginosa








E. coacae
1
1
13.0
1
0
37.0


TOTAL
29
24
31.9
30
2
22.4









Samples were obtained in the peri-operative period and in the following week after intra-operative lavage with saline solution only (control group) or saline solution and ORP water solution (study group). The average hospital stay was then analyzed for each microorganism isolated at entry and for the whole group.
The average numbers of microorganisms grown from these samples were 29 in the control and 30 in the study group. The microorganisms isolated are shown in Table 8. Escherichia coli, Enterococcus, Staphylococcus aureus, Pseudomonas aeruginosa and fungi were isolated from these groups in 3/6, 4/2, 10/8, 2/3 and 10/7 occasions, respectively. Positive cultures for A. xilosoxidans (1), coagulase negative Staphylococci (2) and A. baumanii (1) were only found in the study group.
A second intra-abdominal culture was taken during the first week after surgery (Table 8). At this time, the average number of organisms isolated in the control group (24) was almost the same as in the peri-operative sample (29). Importantly, there was a strong reduction in the number of positive samples in the study group. From 30 positive cultures in the peri-operative samples, only one remained positive for S. aureus and another one for E. coli. In the analysis of hospital days, the control group had a longer stay (31.9 days) in comparison to the study group (22.4 days). Thus, the ORP water solution effectively reduced the peritoneal bacterial load and length of hospital stay in patients with peritonitis.
The mortality rates were also analyzed. There were six deaths in the control group and 3 in the study one. All deaths occurred in the first 30 days after the first surgery and the calculated relative risk was higher for the control group (i.e. 3.3 versus 0). However, the sample size was too small to achieve statistical significance. No local side effects were recorded with the use of ORP water in the IOPL. Surviving patients in the study group were followed for 6 to 12 months. None of the 20 patients in the ORP water-treated group presented intestinal occlusion or data suggesting sclerosing peritonitis in the follow-up period.
Example 19
This example demonstrates the effectiveness of an exemplary ORP water solution (Mycrocyn) in inhibiting mast cell degranulation. Mast cells have been recognized as principal players in type I hypersensitivity disorders. Multiple clinical symptoms observed in atopic dermatitis, allergic rhinitis, and atopic asthma are produced by IgE-antigen stimulation of mast cells located in distinct affected tissues. The currently accepted view of the pathogenesis of atopic asthma is that allergens initiate the process by triggering IgE-bearing pulmonary mast cells (MCs) to release mediators such as histamine, leukotrienes, prostaglandins, kininis, platelet activating factor (PAF), etc. in the so-called early phase of the reaction. In turn, these mediators induce bronchoconstriction and enhance vascular permeability and mucus production. According to this model, following mast cell activation, those cells secrete various pro-inflammatory cytokines, including tumor necrosis factor alpha (TNF-α), IL-4, IL-5 and IL-6, which participate in the local recruitment and activation of other inflammatory cells such as eosinophils, basophils, T lymphocytes, platelets and mononuclear phagocytes. These recruited cells, in turn, contribute to the development of an inflammatory response that may then become autonomous and aggravate the asthmatic symptoms. This late phase response constitutes a long term inflammation process which can induce plastic changes in surrounding tissues (see Kumar et al., pp. 193-268). In experimental models of peritonitis in mice, it has been also been shown that the principal source of pro-inflammatory cytokines in the peritoneal cavity is the mast cell. These cytokines are relevant because they induce the formation of adhesions, abscesses, systemic inflammatory reponse syndrome (SIRS) and multi-organ failure.
Antigenic stimulation of mast cells occurs via the activation of the high affinity receptor for IgE (the FcεRI receptor), which is a multimeric protein that binds IgE and subsequently can be aggregated by the interaction of the receptor-bound IgE with a specific antigen. Its structure comprises four polypeptides, an IgE binding a chain, a β chain that serves to amplify its signaling capacity, and two disulfide-linked γ chains, which are the principal signal transducers via the encoded immunoreceptor tyrosine-based (ITAM) activation motif. Signaling pathways activated by the cross-linking of this receptor have been characterized using bone marrow-derived mast cells (BMMC), the rat leukemia cell line RBL 2H3, mouse and rat peritoneal mast cells, and other mast cell lines, such as MC-9, In all of them, the presence of antigen bound to IgE causes mast cell degranulation, calcium mobilization, cytoskeletal re-arrangements and activation of different transcription factors (NFAT, NFκB, AP-1, PU.1, SP1, Ets, etc.) which activate cytokine gene transcription that culminate with cytokine production.
Mature murine BMMC were loaded with a monoclonal anti-Dinitrophenol IgE (300 ng/million cell) during 4 hours at 37° C. Culture media was removed and cells were resuspended in physiological buffer (Tyrode's Buffer/BSA). Cells were then treated 15 minutes at 37° C. with distinct concentrations of the ORP water solution (Microcyn). Buffer was removed and cells were resuspended in fresh Tyrode's/BSA and stimulated with different concentrations of antigen (Human Albumin coupled to Dinitrophenol) during a 30 minute incubation at 37° C. Degranulation was measured by β-hexosaminidase activity determination in supernatants and pellets of the stimulated cells, using a colorimetric reaction based on the capacity of this enzyme to hydrolize distinct carbohydrates. (β-hexosaminidase has been shown to be located in the same granules that contain histamine in mast cells.) The results (FIG. 7) demonstrate that degranulation is significantly reduced with increasing concentrations of the ORP water solution.
Surprisingly, the inhibitory effect of the ORP water solution (Microcyn) on mast cell degranulation is at least similar to that observed with the clinically effective “mast cell stabilizer” and established anti-allergic compound sodium cromoglycate (IntelTM). Degranulation was again measured by β-hexosaminidase enzymatic activity in the pellet and supernatant of stimulated cells, using a colorimetric reaction based on the capacity of this enzyme to hydrolize distinct carbohydrates. Cells loaded with anti-DNP monoclonal IgE were stimulated with or without a 15 minute pre-incubation with sodium cromoglycate (IntelTM). Cromoglycate was no more effective than the ORP water solution in reducing degranulations (Compare FIG. 7 with FIG. 8; both achieving at least about 50% reduction in degranulation.)
Example 20
This example demonstrates the inhibitory activity of an exemplary ORP water solution on mast cell activation by a calcium ionophore.
Mast cells can be stimulated via the activation of calcium fluxes induced by a calcium ionophore. Signaling pathways activated by calcium ionophores have been characterized using bone marrow-derived mast cells (BMMC), the rat leukemia cell line RBL 2H3, mouse and rat peritoneal mast cells, and other mast cell lines, such as MC-9. In all of these systems the calcium mobilization causes mast cell degranulation (e.g. histamine release), cytoskeletal re-arrangements, and activation of different transcription factors (e.g., NFAT, NFκB, AP-1, PU.1, SP1, Ets.) which activate cytokine gene transcription that culminate with cytokine production and secretion.
Mature murine bone marrow-derived mast cells (BMMC) were loaded with a monoclonal anti-Dinitrophenol IgE (300 ng/million cell) during 4 hours at 37° C. Culture media was removed and cells were resuspended in physiological buffer (Tyrode's Buffer/BSA). Cells were then treated for 15 minutes at 37° C. with distinct concentrations of the ORP water solution (Microcyn). Buffer was removed and cells were resuspended in fresh Tyrode's/BSA and stimulated with calcium ionophore (100 mM A23187) during a 30 minute incubation at 37° C. Degranulation was measured by β-hexosaminidase activity determination in supernatants and pellets of the stimulated cells, using a colorimetric reaction based on the capacity of this enzyme to hydrolyze distinct carbohydrates. (β-hexosaminidase has been shown to be located in the same granules that contain histamine in mast cells.) The results (FIG. 9) demonstrate that degranulation is significantly reduced with increasing concentrations of the ORP water solution.
These results suggest that ORP water solution is a non-specific inhibitor of histamine release. Thus, ORP water solution—even at different concentrations—will inhibit the degranulation of mast cells independently of the stimulus (e.g. antigen or ionophore). While not desiring to be bound by any theory, ORP water solution probably modifies the secretory pathway system at the level of the plasma membrane and/or cytoskeleton. Because the mechanism of action of ORP water solution is believed to be non-specific, it is believed that ORP water solution can have broad potential clinical applications.
Example 21
This example demonstrates the effect of an exemplary ORP water solution on the activation of mast cell cytokine gene transcription.
FIGS. 10A and 10B is an RNAase protection assay from mast cells treated with ORP water solution at different concentrations for 15 minutes and further stimulated by antigen as described in Example 19. After stimulation, mRNA was extracted using affinity chromatography columns (RNAeasy kit, Qiagene) and the RNAse Protection Assay was performed using standard kit conditions (Clontech, Becton & Dickinson) in order to detect mRNA production of distinct cytokines after antigen challenge. The cytokines included TNF-α, LIF, IL13, M-CSF, IL6, MIF and L32.
FIGS. 10A and 10B show that the ORP solution water (Microcyn) did not modify cytokine mRNA levels after antigen challenge in mast cells irrespective of the concentrations of ORP water solution or antigen used for the experiment.
In this study, the level of transcripts (i.e., the RNA content of stimulated mast cells) of proinflammatory genes was not changed in ORP water solution-treated mast cells after being stimulated with various concentrations of antigen. Thus, the ORP water solution inhibited the secretory pathway of these cytokines without affecting their transcription.
Example 22
This example demonstrates the inhibitory activity of an exemplary ORP water solution on mast cell secretion of TNF-α.
Mast cells were treated with different concentrations of ORP water solution for 15 minutes and further stimulated by antigen as described in Example 19, Thereafter, the tissue culture medium was replaced and samples of the fresh medium were collected at various periods of time (2-8 hours) for measuring TNF-α levels. Samples were frozen and further analyzed with a commercial ELISA kit (Biosource) according to the manufacturer's instructions.
FIG. 11 shows that the level of secreted TNF-α to the medium from ORP water solution-treated cells after antigen stimulation is significantly decreased in comparison to the untreated cells.
Thus, the ORP water solution inhibited TNF-α secretion of antigen-stimulated mast cells. These results are in agreement with clinical observations that the use of ORP water solutions can decrease the inflammatory reaction in various wounds after surgical procedures.
Example 23
This example demonstrates the inhibitory activity of an exemplary ORP water solution on mast cell secretion of MIP 1-α.
Mast cells were treated with different concentrations of an exemplary ORP water solution (Microcyn) for 15 minutes and further stimulated by antigen as described in Example 19. Thereafter, the tissue culture medium was replaced and samples of the fresh medium were collected at various periods of time (2-8 hours) for measuring MIP 1-α levels. Samples were frozen and further analyzed with a commercial ELISA kit (Biosource) according to the manufacturer's instructions.
FIG. 12 shows that the level of secreted MIP 1-α to the medium from ORP water solution-treated cells after antigen stimulation was significantly decreased in comparison to the untreated cells.
Thus, the ORP water solution inhibited MIP 1-α secretion of antigen-stimulated mast cells. These results are in agreement with clinical observations that the use of ORP water solutions can decrease the inflammatory reaction in various wounds after surgical procedures.
The results of analogous studies measuring IL-6 and IL-13 secretion are depicted in FIGS. 13 and 14.
Examples 20-23 and this example further demonstrate that the ORP water solution is able to inhibit early and late phase allergic responses initiated by IgE receptor crosslinking.
Example 24
This example demonstrates the results of a toxicity study using an exemplary ORP water solution.
An acute systemic toxicity study was performed in mice to determine the potential systemic toxicity of an exemplary ORP water solution, Microcyn 60. A single dose (50 mL/kg) of Microcyn 60 was injected intraperitoneally in five mice. Five control mice were injected with a single dose (50 mL/kg) of saline (0.9% sodium chloride). All animals were observed for mortality and adverse reactions immediately following the injection, at 4 hours after injection, and then once daily for 7 days. All animals were also weighed prior to the injection and again on Day 7. There was no mortality during the study. All animals appeared clinically normal throughout the study. All animals gained weight. The estimated Microcyn 60 acute intraperitoneal LD50 from this study is greater than 50 mL/kg. This example demonstrates that Microcyn 60 lacks significant toxicity and should be safe for therapeutic use accordance with the invention.
Example 25
This example illustrates a study conducted to determine the potential cytogenetic toxicity of an exemplary ORP water solution.
A micronucleus test was performed using an exemplary ORP water solution (10% Microcyn) to evaluate the mutagenic potential of intraperitoneal injection of an ORP water solution into mice. The mammalian in vivo micronucleus test is used for the identification of substances which cause damage to chromosomes or the mitotic apparatus of murine polychromatic erythrocytes. This damage results in the formation of “micronuclei,” intracellular structures containing lagging chromosome fragments or isolated whole chromosomes. The ORP water solution study included 3 groups of 10 mice each (5 males/5 females): a test group, dosed with the ORP water solution; a negative control group, dosed with a 0.9% NaCl solution; and a positive control group, dosed with a mutagenic cyclophosphamide solution. The test and the negative control groups received an intraperitoneal injection (12.5 ml/kg) of the ORP water solution or 0.9% NaCl solution, respectively, for two consecutive days (days 1 and 2). The positive control mice received a single intraperitoneal injection of cyclophosphamide (8 mg/mL, 12.5 ml/kg) on day 2. All mice were observed immediately after injection for any adverse reactions. All animals appeared clinically normal throughout the study and no sign of toxicity was noted in any group. On day 3, all mice were weighed and terminated.
The femurs were excised from the terminated mice, the bone marrow was extracted, and duplicate smear preparations were performed for each mouse. The bone marrow slides for each animal were read at 40× magnification. The ratio of polychromatic erythrocytes (PCE) to normochromatic erythrocytes (NCE), an index of bone marrow toxicity, was determined for each mouse by counting a total of at least 200 erythrocytes. Then a minimum of 2000 scoreable PCE per mouse were evaluated for the incidence of micronucleated polychromatic erythrocytes. Statistical analysis of the data were done using the Mann and Whitney test (at 5% risk threshold) from a statistical software package (Statview 5.0, SAS Institute Inc., USA).
The positive control mice had statistically significant lower PCE/NCE ratios when compared to their respective negative controls (males: 0.77 vs. 0.90 and females: 0.73 vs. 1.02), showing the toxicity of the cyclophosphamide on treated bone marrow. However, there was no statistically significant difference between the PCE/NCE ratios for the ORP water solution-treated mice and negative controls. Similarly, positive control mice had a statistically significant higher number of polychromatic erythrocytes bearing micronuclei as compared to both the ORP water solution-treated mice (males: 11.0 vs. 1.4/females: 12.6 vs. 0.8) and the negative controls (males: 11.0 vs. 0.6/females: 12.6 vs. 1.0). There was no statistically significant difference between the number of polychromatic erythrocytes bearing micronculei in ORP water solution-treated and negative control mice.
This example demonstrates that 10% Microcyn did not induce toxicity or mutagenic effects after intraperitoneal injections into mice.
Example 26
This study demonstrates the lack of toxicity of an exemplary ORP water solution, Dermacyn.
This study was done in accordance with ISO 10993-5:1999 standard to determine the potential of an exemplary ORP water solution, Dermacyn, to cause cytotoxicity. A filter disc with 0.1 mL of Dermacyn was placed onto an agarose surface, directly overlaying a monolayer of mouse fibroblast cells (L-929). The prepared samples were observed for cytotoxic damage after 24 hours of incubation at 37° C. in the presence of 5% CO2. Observations were compared to positive and negative control samples. The Dermacyn containing samples did not reveal any evidence of cell lysis or toxicity, while positive and negative control performed as anticipated.
Based on this study Dermacyn was concluded not to generate cytotoxic effects on murine fibroblasts.
Example 27
This study was conducted with 16 rats to evaluate the local tolerability of an exemplary ORP water solution, Dermacyn, and its effects on the histopathology of wound beds in a model of full-thickness dermal wound healing. Wounds were made on both sides of the subject rat. During the healing process skin sections were taken on either the left or the right sides (e.g., Dermacyn-treated and saline-treated, respectively).
Masson's trichrome-stained sections and Collagen Type II stained sections of the Dermacyn and saline-treated surgical wound sites were evaluated by a board-certified veterinary pathologist. The sections were assessed for the amount of Collagen Type 2 expression as a manifestiation of connective tissue proliferation, fibroblast morphology and collagen formation, presence of neoepidermis in cross section, inflammation and extent of dermal ulceration.
The findings indicate that Dermacyn was well tolerated in rats. There were no treatment-related histopathologic lesions in the skin sections from either sides' wounds (Dermacyn-treated and saline-treated, respectively). There were no relevant histopathologic differences between the saline-treated and the Dermacyn-treated wound sites, indicating that the Dermacyn-treatement was well tolerated. There were no significant differences between Collagen Type 2 expression between the saline-treated and the DermacynTM-treated wound sites indicating that the Dermacyn does not have an adverse effect on fibroblasts or on collagen elaboration during wound healing.
Example 28
This example demonstrates the use of an exemplary oxidative reductive potential water, Microcyn, in accordance with the invention as an effective antimicrobial solution.
An In-Vitro Time-Kill evaluation was performed using Microcyn oxidative reductive potential water. Microcyn was evaluated versus challenge suspensions of fifty different microorganism strains—twenty-five American Type Culture Collection (ATCC) strains and twenty-five Clinical Isolates of those same species—as described in the Tentative Final Monograph, Federal Register, 17 Jun. 1994, vol. 59:116, pg. 31444. The percent reductions and the Log10 reductions from the initial population of each challenge strain were determined following exposures to Microcyn for thirty (30) seconds, one (1) minute, three (3) minutes, five (5) minutes, seven (7) minutes, nine (9) minutes, eleven (11) minutes, thirteen (13) minutes, fifteen (15) minutes, and twenty (20) minutes. All agar-plating was performed in duplicate and Microcyn was evaluated at a 99% (v/v) concentration. All testing was performed in accordance with Good Laboratory Practices, as specified in 21 C.F.R. Part 58.
The following table summarizes the results of the abovementioned In-Vitro Time-Kill evaluation at the thirty second exposure mark for all populations tested which were reduced by more than 5.0 Log10:







TABLE 8







30-Second In-Vitro Kill.














Initial
Post-Exposure






Population
Population
Log10
Percent


No.
Microorganism Species
(CFU/mL)
(CFU/mL)
Reduction
Reduction















1
Acinetobacter baumannii
 2.340 × 109
<1.00 × 103
6.3692
99.9999



(ATCC #19003)






2
Acinetobacter baumannii
1.8150 × 109
<1.00 × 103
6.2589
99.9999



Clinical Isolate







BSLI #061901Ab3






3
Bacteroides fragilis
  4.40 × 1010
<1.00 × 103
7.6435
99.9999



(ATCC #43858)






4
Bacteroides fragilis
  2.70 × 1010
<1.00 × 103
7.4314
99.9999



Clinical Isolate







BSLI #061901Bf6






5
Candida albicans
  2.70 × 1010
<1.00 x 103
6.3345
99.9999



(ATCC #10231)






6
Candida albicans
 5.650 × 109
<1.00 × 103
6.7520
99.9999



Clinical Isolate







BSLI #042905Ca






7
Enterobacter aerogenes
1.2250 × 109
<1.00 × 103
6.0881
99.9999



(ATCC #29007)






8
Enterobacter aerogenes
1.0150 × 109
<1.00 × 103
6.0065
99.9999



Clinical Isolate







BSLI #042905Ea






9
Enterococcus faecalis
 2.610 × 109
<1.00 × 103
6.4166
99.9999



(ATCC #29212)






10
Enteroccccus faecalis
1.2850 × 109
<1.00 × 103
6.1089
99.9999



Clinical Isolate







BSLI #061901Efs2






11
Enterococcus faecium
 3.250 × 109
<1.00 × 103
6.5119
99.9999



VRE, MDR







(ATCC #51559)






12
Enterococcus faecium
 1.130 × 109
<1.00 x 103
6.0531
99.9999



Clinical Isolate







BSLI #061901Efm1






13
Escherichia coli
 5.00 × 108
<1.00 × 103
5.6990
99.9998



(ATCC #11229)






14
Escherichia coli
 3.950 × 108
<1.00 × 103
5.5966
99.9997



Clinical Isolate







BSLI #042905Ec1






15
Escherichia coli
 6.650 × 108
<1.00 × 103
5.8228
99.9998



(ATCC #25922)






16
Escherichia coli
 7.40 × 108
<1.00 × 103
5.8692
99.9998



Clinical Isolate







BSLI #042905Ec2






17
Haemophilus influenzae
1.5050 × 109
<1.00 × 104
5.1775
99.9993



(ATCC #8149)






18
Haemophilus influenzae
 1.90 × 109
<1.00 × 104
5.2788
99.9995



Clinical Isolate







BSLI #072605Hi






19
Klebsiella oxytoca
 1.120 × 109
<1.00 × 103
6.0492
99.9999



MDR







(ATCC #15764)






20
Klebsiella oxytoca
 1.810 × 109
<1.00 × 103
6.2577
99.9999



Clinical Isolate







BSLI #061901Ko1






21
Klebsiella pneumoniae
 1.390 × 109
<1.00 × 103
6.1430
99.9999



subsp. ozaenae







(ATCC #29019)






22
Klebsiella pneumoniae
 9.950 × 108
<1.00 × 103
5.9978
99.9999



Clinical Isolate







BSLI #061901Kpn2






23
Micrococcus luteus
 6.950 × 108
<1.00 × 103
5.8420
99.9999



(ATCC #7468)






24
Micrococcus luteus
1.5150 × 109
<1.00 × 103
6.1804
99.9999



Clinical Isolate







BSLI #061901M12






25
Proteus mirabilis
1.5950 × 109
<1.00 × 103
6.2028
99.9999



(ATCC #7002)






26
Proteus mirabilis
2.0950 × 109
<1.00 × 103
6.3212
99.9999



Clinical Isolate







BSLI #061901Pm2






27
Pseudomonas aeruginosa
 6.450 × 108
<1.00 × 103
5.8096
99.9999



(ATCC #15442)






28
Pseudomonas aeruginosa
1.3850 × 109
<1.00 × 103
6.1414
99.9999



Clinical Isolate







BSLI #072605Pa






29
Pseudomonas aeruginosa
 5.550 × 108
<1.00 × 103
5.7443
99.9999



(ATCC #27853)






30
Pseudomonas aeruginosa
1.1650 × 109
<1.00 × 103
6.0663
99.9999



Clinical Isolate







BSLI #061901Pa2






31
Serratia marcescens
 9.950 × 108
<1.00 × 103
5.9978
99.9999



(ATCC #14756)






32
Serratia marcescens
3.6650 × 109
<1.00 × 103
6.5641
99.9999



Clinical Isolate







BSLI #042905Sm






33
Staphylococcus aureus
1.5050 × 109
<1.00 × 103
6.1775
99.9999



(ATCC #6538)






34
Staphylococcus aureus
 1.250 × 109
<1.00 × 103
6.0969
99.9999



Clinical Isolate







BSLI #061901Sa1






35
Staphylococcus aureus
 1.740 × 109
<1.00 × 103
6.2405
99.9999



(ATCC #29213)






36
Staphylococcus aureus
1.1050 × 109
<1.00 × 103
6.0434
99.9999



Clinical Isolate







BSLI #061901Sa2






37
Staphylococcus epidermidis
1.0550 × 109
<1.00 × 103
6.0233
99.9999



(ATCC #12228)






38
Staphylococcus epidermidis
 4.350 × 108
<1.00 × 103
5.6385
99.9998



Clinical Isolate







BSLI #072605Se






39
Staphylococcus haemolyticus
 8.150 × 108
<1.00 × 103
5.9112
99.9999



(ATCC #29970)






40
Staphylococcus haemolyticus
 8.350 × 108
<1.00 × 103
5.9217
99.9999



Clinical Isolate







BSLI #042905Sha






41
Staphylococcus hominis
 2.790 × 108
<1.00 × 103
5.4456
99.9996



(ATCC #27844)






42
Staphylococcus hominis
 5.20 × 108
<1.00 × 103
5.7160
99.9998



Clinical Isolate







BSLI #042905Sho






43
Staphylococcus saprophyticus
 9.10 × 108
<1.00 × 103
5.9590
99.9999



(ATCC #35552)






44
Staphylococcus saprophyticus
1.4150 × 109
<1.00 × 103
6.1508
99.9999



Clinical Isolate







BSLI #042905Ss






45
Streptococcus pneumoniae
2.1450 × 109
<1.00 × 103
5.3314
99.9995



(ATCC #33400)






46
Streptococcus pyogenes
 5.20 × 109
<1.00 × 103
6.7160
99.9999



(ATCC #19615)






47
Streptococcus pyogenes
2.5920 × 109
<1.00 × 103
6.4141
99.9999



Clinical Isolate







BSLI #061901Spy7









While their microbial reductions were measured at less than 5.0 Log10, Microcyn also demonstrated antimicrobial activity against the remaining three species not included in Table 8. More specifically, a thirty second exposure to Microcyn reduced the population of Streptococcus pneumoniae (Clinical Isolate; BSLI #072605Spn1) by more than 4.5 Log10, which was the limit of detection versus this species. Further, when challenged with Candida tropicalis (ATCC #750), Microcyn demonstrated a microbial reduction in excess of 3.0 Log10 following a thirty second exposure. Additionally, when challenged with Candida tropicalis (BSLI #042905Ct), Microcyn demonstrated a microbial reduction in excess of 3.0 Log10 following a twenty minute exposure.
The exemplary results of this In-Vitro Time-Kill evaluation demonstrate that Microcyn oxidative reductive potential water exhibits rapid (i.e., less than 30 seconds in most cases) antimicrobial activity versus a broad spectrum of challenging microorganisms. Microbial populations of forty-seven out of the fifty Gram-positive, Gram-negative, and yeast species evaluated were reduced by more than 5.0 Log10 within thirty seconds of exposure to the product.
Example 29
This example demonstrates a comparison of the antimicrobial activity of an exemplary oxidative reductive potential water, Microcyn, used in accordance with the invention versus HIBICLENS® chlorhexidine gluconate solution 4.0% (w/v) and 0.9% sodium chloride irrigation (USP).
An In-Vitro Time-Kill evaluation was performed as described in Example 28 using HIBICLENS® chlorhexidine gluconate solution 4.0% (w/v) and a sterile 0.9% sodium chloride irrigation solution (USP) as reference products. Each reference product was evaluated versus suspensions of the ten American Type Culture Collection (ATCC) strains specifically denoted in the Tentative Final Monograph. The data collected was then analyzed against the Microcyn microbial reduction activity recorded in Example 28.
Microcyn oxidative reductive potential water reduced microbial populations of five of the challenge strains to a level comparable to that observed for the HEBICLENS® chlorhexidine gluconate solution. Both Microcyn and HIBICLENS® provided a microbial reduction of more than 5.0 Log10 following a thirty second exposure to the following species: Escherichia coli (ATCC #11229 and ATCC #25922), Pseudomonas aeruginosa (ATCC #15442 and ATCC #27853), and Serratia marcescens (ATCC #14756). Further, as shown above in Table 8, Microcyn demonstrated excellent antimicrobial activity against Micrococcus luteus (ATCC #7468) by providing a 5.8420 Log10 reduction after a thirty second exposure. However, a direct Micrococcus luteus (ATCC #7468) activity comparison to HIBICLENS® was not possible because after a thirty second exposure, HIBICLENS® reduced the population by the detection limit of the test (in this specific case, by more than 4.8 Log10). It is noted that the sterile 0.9% sodium chloride irrigation solution reduced microbial populations of each of the six challenge strains discussed above by less than 0.3 Log10 following a full twenty minute exposure.
Microcyn oxidative reductive potential water provided greater antimicrobial activity than both HIBICLENS® and the sodium chloride irrigation for four of the challenge strains tested: Enterococcus faecalis (ATCC #29212), Staphylococcus aureus (ATCC #6538 and ATCC #29213), and Staphylococcus epidermidis (ATCC #12228). The following table summarizes the microbial reduction results of the In-Vitro Time-Kill evaluation for these four species:







TABLE 9







Comparative Results









Log10 Reduction











Microorganism
Exposure


NaCl


Species
Time
Microcyn
HIBICLENS ®
Irrigation















Enterococcus
30
seconds
6.4166
1.6004
0.3180


faecalis
1
minute
6.4166
2.4648
0.2478


(ATCC #29212)
3
minutes
6.4166
5.2405
0.2376



5
minutes
6.4166
5.4166
0.2305



7
minutes
6.4166
5.4166
0.2736



9
minutes
6.4166
5.4166
0.2895



11
minutes
6.4166
5.4166
0.2221



13
minutes
6.4166
5.4166
0.2783



15
minutes
6.4166
5.4166
0.2098



20
minutes
6.4166
5.4166
0.2847


Staphylococcus
30
seconds
6.1775
1.1130
0.0000


aureus
1
minute
6.1775
1.7650
0.0191


(ATCC #6538)
3
minutes
6.1775
4.3024
0.0000



5
minutes
6.1775
5.1775
0.0000



7
minutes
6.1775
5.1775
0.0000



9
minutes
6.1775
5.1775
0.0000



11
minutes
6.1775
5.1775
0.0267



13
minutes
6.1775
5.1775
0.0000



15
minutes
6.1775
5.1775
0.0191



20
minutes
6.1775
5.1775
0.0000


Staphylococcus
30
seconds
6.2405
0.9309
0.0000


aureus
1
minute
6.2405
1.6173
0.0000


(ATCC #29213)
3
minutes
6.2405
3.8091
0.0460



5
minutes
6.2405
5.2405
0.0139



7
minutes
6.2405
5.2405
0.0000



9
minutes
6.2405
5.2405
0.0113



11
minutes
6.2405
5.2405
0.0283



13
minutes
6.2405
5.2405
0.0000



15
minutes
6.2405
5.2405
0.0000



20
minutes
6.2405
5.2405
0.0615


Staphylococcus
30
seconds
5.6385
5.0233
0.0456


epidermidis
1
minute
5.6385
5.0233
0.0410


(ATCC #12228)
3
minutes
5.6385
5.0233
0.0715



5
minutes
5.6385
5.0233
0.0888



7
minutes
5.6385
5.0233
0.0063



9
minutes
5.6385
5.0233
0.0643



11
minutes
5.6385
5.0233
0.0211



13
minutes
5.6385
5.0233
0.1121



15
minutes
5.6385
5.0233
0.0321



20
minutes
5.6385
5.0233
0.1042









The results of this comparative In-Vitro Time-Kill evaluation demonstrate that Microcyn oxidative reductive potential water not only exhibits comparable antimicrobial activity to HIBICLENS® against Escherichia coli (ATCC #11229 and ATCC #25922), Pseudomonas aeruginosa (ATCC #15442 and ATCC #27853), Serratia marcescens (ATCC #14756), and Micrococcus luteus (ATCC #7468), but provides more effective treatment against Enterococcus faecalis (ATCC #29212), Staphylococcus aureus (ATCC #6538 and ATCC #29213), and Staphylococcus epidermidis (ATCC #12228). As shown in Table 9, Microcyn exemplifies a more rapid antimicrobial response (i.e., less than 30 seconds) in some species. Moreover, exposure to Microcyn results in a greater overall microbial reduction in all species listed in Table 9.
Example 30
This example demonstrates the effectiveness of an ORP water solution against Penicillin Resistant Streptococcus pneumoniae (ATCC 51915).
A culture of Streptococcus pneumoniae was prepared by using a frozen culture to inoculate multiple BAP plates and incubating for 2-3 days at 35-37° C. with CO2. Following incubation 3-7 mL of sterile diluent/medium was transferred to each agar plate and swabbed to suspend the organism. The suspensions from all plates were collected and transferred to a sterile tube and compared to a 4.0 McFarland Standard. The suspension was filtered through sterile gauze and vortex mixed prior to use in the testing procedure.
An inoculum of 0.1 ml of the organism suspension was added to 49.9 ml of the Microcyn or control substance. At each exposure period, the test mixture was mixed by swirling. The test mixture was exposed for 15 seconds, 30 seconds, 60 seconds, 120 seconds, 5 minutes, and 15 minutes at 25.0° C.
A 1.0 ml sample was removed from the test mixture and added to 9.0 ml of neutralizer representing a 100 dilution of the neutralized inoculated test mixture. A 5 ml aliquot of the 100 neutralized inoculated test mixture was transferred to a 0.45 microliter filter apparatus pre-wetted with 10 ml of Butterfield's Buffer. The filter was rinsed with approximately 50 mL of Butterfield's Buffer, aseptically removed from the apparatus, and transferred to a BAP plate. Additional 1:10 serial dilutions were prepared and one (1.0) ml aliquots of the 10-3-10-4 dilutions of neutralized inoculated test mixture were plated in duplicate on BAP.
The bacterial subculture plates were incubated for 48±4 hours at 35-37° C. in C02. Subculture plates were refrigerated for two days at 2-8° C. prior to examination. Following incubation and storage, the agar plates were observed visually for the presence of growth. The colony forming units were enumerated and the number of survivors at each exposure time was determined. Representative subcultures demonstrating growth were appropriately examined for confirmation of the test organisms.
The exemplary ORP water solution, Microcyn, demonstrated a >99.93197279% reduction of Penicillin Resistant Streptococcus pneumoniae (ATCC 51915) after 15 second, 30 second, 60 second, 120 second, 5 minute, and 15 minute contact times at 25.0° C.
Example 31
The objective of this Example is to determine the microbial activity of an exemplary ORP water solution (Dermacyn) versus Bacitracin using a bacterial suspension assay.
Dermacyn is a ready to use product, therefore performing dilutions during testing was not required. Bacitracin is a concentrated re-hydrated solution requiring a dilution to 33 Units/ml.
A purchased spore suspension of B. atropheus at 2.5×107/ml was used for testing. In addition fresh suspensions of Pseudomonas aeruginosa, and Staphylococcus aureus were prepared and measured using a spectrophotometer to ensure the titer was acceptable
Nine microliters of test substance was added to 100 ul of microbe suspension. The test mixture was held at 20° C. for the contact times of 20 seconds, 5 minutes, and 20 minutes. 1.0 ml of the test mixture (entire mixture) was added to 9.0 ml of neutralizer for 20 minutes (this is the original neutralization tube or ONT) 1.0 ml of the neutralized test mixture was plated on Tryptic Soy Agar in duplicate for the 5 minute and 20 minute contact times. Additional dilutions and spread plates were used for the 20 second time point, to achieve countable plates.
All plates were incubated at 30° C.-35° C. for a total of 3 days and were evaluated after each day of incubation. To determine the number of microbes exposed to Dermacyn and Bacitracin during testing the suspensions Four 10-fold dilutions were performed and 1.0 ml of the final 2 dilutions was plated in duplicate, where applicable.
Dermacyn when challenged with the test organisms showed total eradication (>4 log reduction) of the vegetative bacteria at all time points and for spores at the 5, and 20 minute time points. Bacitracin only produced approximately 1 log reduction. Microcyn at the 20 second time point showed some reduction in spores. Bacitracin showed no evidence of lowering the bacterial or spore populations over the time periods tested.
Example 32
This example demonstrates the effectiveness of two exemplary ORP water solutions (M1 and M2) against bacteria in biofilms.
The parental strain for all studies is P. aeruginosa PAO1. All planktonic strains were grown aerobically in minimal medium (2.56 g Na2HPO4, 2.08 g KH2PO4, 1.0 g NH4Cl, 0.04 g CaCl2.2H2O, 0.5 g MgSO4.7H2O, 0.1 mg CuSO4.5H2O, 0.1 mg ZnSO4.H2O, 0.1 mg FeSO4.7H2O, and 0.004 mg MnCl2.4H2O per liter, pH 7.2) at 22° C. in shake flasks at 220 rpm. Biofilms were grown as described below at 22° C. in minimal medium. Glutamate (130 mg/liter) was used as the sole carbon source.
Biofilms were grown as described previously (Sauer et. al., J. Bacteriol. 184:1140-1154 (2002), which is hereby incorporated by reference). Briefly, the interior surfaces of silicone tubing of a once-through continuous flow tube reactor system were used to cultivate biofilms at 22° C. Biofilms were harvested after 3 days (maturation-1 stage), 6 days (maturation-2 stage), and 9 days (dispersion stage) of growth under flowing conditions. Biofilm cells were harvested from the interior surface by pinching the tube along its entire length, resulting in extrusion of the cell material from the lumen. The resulting cell paste was collected on ice. Prior to sampling, the bulk liquid was purged from the tubing to prevent interference from detached, planktonic cells.
The population size of planktonic and biofilm cells was determined by the number of CFU by using serial dilution plate counts. To do so, biofilms were harvested from the interior surface after various periods of time of exposure to SOSs. Images of biofilms grown in once-through flow cells were viewed by transmitted light with an Olympus BX60 microscope (Olympus, Melville, N.Y.) and a 100 magnification A100PL objective lens. Images were captured using a Magnafire cooled three-chip charge-coupled device camera (Optronics Inc., Galena, Calif.) and a 30-ms exposure. In addition, confocal scanning laser microscopy was performed with an LSM 510 Meta inverted microscope (Zeiss, Heidelberg, Germany). Images were obtained with a LD-Apochrome 40/0.6 lens and with the LSM 510 Meta software (Zeiss).
A 2-log reduction was observed for M1-treated biofilms within 60 min of treatment. The finding indicates that every 10.8 min (+/−2.8 min), treatment with M1 results in a 50% reduction in biofilm viability.







TABLE 10







M1 Killing.










Time (min)
Viability (%)













0
100



10
50



20
25



34
12.5



47
6.25



54
3.125









However, overall M2 was somewhat more effective in killing biofilms than M1 because the results indicated that every 4.0 min (+/−1.2 min), treatment with M2 results in a 50% reduction in biofilm viability.







TABLE 11







M2 Killing.










Time (min)
Viability (%)













0
100



2.5
50



7
25



12
12.5



15
6.25



20
3.125









Thus, ORP water is effective against bacteria in biofilms.
All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.
The use of the terms “a” and “an” and “the” and similar referents in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms “comprising,” “having,” “including,” and “containing” are to be construed as open-ended terms (i.e., meaning “including, but not limited to,”) unless otherwise noted. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.
Preferred embodiments of this invention are described herein, including the best mode known to the inventors for carrying out the invention. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventors expect skilled artisans to employ such variations as appropriate, and the inventors intend for the invention to be practiced otherwise than as specifically described in the examples. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.

## Claims

1. A method of preventing or treating peritonitis in a patient, the method comprising administering to the patient a therapeutically effective amount of an oxidative reductive potential water solution, wherein the solution is stable for at least about two months, and the solution has a pH of from about 6.2 to about 7.8, a chlorine dioxide level that is less than about 5 ppm, and wherein the oxidative reductive potential water solution comprises one or more species selected from the group consisting of hypochlorous acid, hypochlorite ions, and combinations thereof.

2. The method of claim 1, comprising contacting the peritoneal tissue in the patient with a therapeutically effective amount of the oxidative reductive potential water solution.

3. The method of claim 1, comprising delivering a therapeutically effective amount of the oxidative reductive potential water solution to the patient's peritoneal space.

4. The method of claim 3, wherein the oxidative reductive potential water solution is delivered to the patient's peritoneal space intra-operatively, laproscopically or transabdominally.

5. The method of claim 3, comprising: (a) gaining access to the peritoneal space in the patient; (b) delivering to the peritoneal space from about 0.1 to about 10 L of the oxidative reductive potential water solution; (c) allowing the oxidative reductive potential water solution to remain in the peritoneal space for a period of time sufficient to provide a therapeutic effect; (d) optionally removing the oxidative reductive potential water solution; and (e) optionally repeating steps (b)-(d).

6. The method of claim 1, wherein the peritonitis results from surgery, appendicitis, acute cholecystitis, peptic ulcer, diverticulitis, bowel obstruction, pancreatitis, pelvic inflammatory disease, mesenteric thrombosis, tumor, penetrating trauma, or a combination thereof.

7. The method of claim 1, wherein the peritonitis is associated with an infection.

8. The method of claim 7, wherein the infection is by one or more microorganisms selected from the group consisting of viruses, bacteria, and fungi.

9. The method of claim 7, wherein the infection is by one or more bacteria.

10. The method of claim 7, wherein the infection is by one or more bacteria selected from the group consisting of Pseudomonas aeruginosa, Escherichia coli, Enterococcus hirae, Acinetobacter baumannii, Acinetobacter species, Bacteroides fragilis, Enterobacter aerogenes, Enterococcus faecalis, Vancomycin resistant-Enterococcus faecium (VRE, MDR), Haemophilus influenzae, Klebsiella oxytoca, Klebsiella pneumoniae, Micrococcus luteus, Proteus mirabilis, Serratia marcescens, Staphylococcus aureus, Methicilin resistant-Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus, Streptococcus pneumoniae, Streptococcus pyogenes, Salmonella choleraesuis, Shigella dysenteriae, C. perfingens, Neisseria gonorrhea, Chlamydia trachomatis, Mycobaterium bovis, Chlamydia trachomatis, and combinations thereof.

11. The method of claim 7, wherein the infection is by one or more fungi selected from the group consisting of Candida albicans, Candida parapsilasis, Candida tropicalis, Trichophyton mentagrophytes and Aspergillus fumigaus.

12. The method of claim 7, wherein the peritonitis is spontaneous bacterial peritonitis.

13. The method of claim 12, wherein the spontaneous bacterial peritonitis arises in a patient with hepatic cirrhosis or the nephrotic syndrome.

14. The method of claim 1, wherein the peritonitis results from an inflammatory condition.

15. The method of claim 1, wherein the peritonitis results from an allergic reaction.

16. The method of claim 1, wherein the peritonitis results from chemical irritation.

17. The method of claim 1, wherein the peritonitis is associated with one or more impaired or damaged tissues.

18. The method of claim 17, wherein the one or more impaired or damaged tissues is infected.

19. The method of claim 18, wherein the infection is by one or more microorganisms selected from the group consisting of viruses, bacteria, and fungi.

20. The method of claim 18, wherein the infection is by one or more bacteria selected from the group consisting of Pseudomonas aeruginosa, Escherichia coli, Enterococcus hirae, Acinetobacter baumannii, Acinetobacter species, Bacteroides fragilis, Enterobacter aerogenes, Enterococcus faecalis, Vancomycin resistant-Enterococcus faecium (VRE, MDR), Haemophilus influenzae, Klebsiella oxytoca, Klebsiella pneumoniae, Micrococcus luteus, Proteus mirabilis, Serratia marcescens, Staphylococcus aureus, Methicilin resistant-Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus, Streptococcus pneumoniae, Streptococcus pyogenes, Salmonella choleraesuis, Shigella dysenteriae, C. perfingens, Neisseria gonorrhea, Chlamydia trachomatis, Mycobaterium bovis, Chlamydia trachomatis, and combinations thereof.

21. The method of claim 18, wherein the infection is by one or more fungi selected from the group consisting of Candida albicans, Candida parapsilasis, Candida tropicalis, Trichophyton mentagrophytes and Aspergillus fumigaus.

22. The method of claim 1, further comprising administering to the patient a therapeutically effective amount of one or more additional therapeutic agents selected from the group consisting of anti-infective agents and anti-inflammatory agents.

23. The method of claim 22, wherein the anti-infective agent is an antibacterial agent.

24. The method of claim 22, wherein the anti-infective agent is an antibiotic.

25. The method of claim 22, wherein the anti-inflammatory agent is selected from the group consisting of steroidal anti-inflammatory drugs, non-steroidal anti-inflammatory drugs, and combinations thereof.

26. The method of claim 1, comprising administering at least one antibiotic and at least one anti-inflammatory agent.

27. The method of claim 1, wherein the pH of the oxidative reductive potential water solution is from about 7.4 to about 7.6.

28. The method of claim 1, wherein the oxidative reductive potential water solution is stable for at least about six months.

29. The method of claim 1, wherein the oxidative reductive potential water solution is stable for at least about one year.

30. The method of claim 1, wherein the oxidative reductive potential water solution is capable of yielding at least about a 106 fold reduction in the concentration of a sample of one or more live microorganisms selected from the group consisting of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, C. perfingens, Neisseria gonorrhea, Chlamydia trachomatis, streptococci, enteroococci, Mycobaterium tuberculosis, Candida albicans, and combinations thereof, after a thirty second exposure, when measured at least about two months after preparation of the solution.

31. The method of claim 1, wherein the oxidative reductive potential water solution comprises cathode water in an amount of from about 10% to about 90% by volume of the solution.

32. The method of claim 1, wherein the oxidative reductive potential water solution comprises cathode water in an amount of from about 10% to about 50% by volume of the solution.

33. The method of claim 1, wherein the oxidative reductive potential water solution comprises cathode water in an amount of from about 20% to about 40% by volume of the solution.

34. The method of claim 1, wherein the oxidative reductive potential water solution comprises anode water in an amount of from about 50% to about 90% by volume of the solution.

35. The method of claim 1, wherein the oxidative reductive potential water solution comprises cathode water in an amount of from about 10% to about 50% by volume of the solution, and anode water in an amount of from about 50% to about 90% by volume of the solution.

36. The method of claim 1, wherein the solution comprises from about 15 ppm to about 35 ppm hypochlorous acid.

37. The method of claim 1, wherein the oxidative reductive potential water solution comprises from about 25 ppm to about 50 ppm sodium hypochlorite.

38. The method of claim 1, wherein the oxidative reductive potential water solution comprises from about 15 ppm to about 35 ppm hypochlorous acid, from about 25 ppm to about 50 ppm sodium hypochlorite, and from about 1 ppm to about 4 ppm of one or more superoxidized water species; has a pH of from about 6.2 to about 7.8; and is stable for at least about two months.

39. The method of claim 1, wherein the oxidative reductive potential water solution water solution has a potential of from about −400 mV to about +1300 mV.

40. A method of preventing peritoneal adhesions in a patient, the method comprising administering to the patient an oxidative reductive potential water solution in an amount effective to prevent peritoneal adhesions, wherein the solution is stable for at least about two months, and the solution has a pH of from about 6.2 to about 7.8, a chlorine dioxide level that is less than about 5 ppm, and wherein the oxidative reductive potential water solution comprises one or more species selected from the group consisting of hypochlorous acid, hypochlorite ions, and combinations thereof.

41. A method of preventing peritoneal abscesses in a patient, the method comprising administering to the patient an oxidative reductive potential water solution in an amount effective to prevent peritoneal abscesses, wherein the solution is stable for at least about two months, and the solution has a pH of from about 6.2 to about 7.8, a chlorine dioxide level that is less than about 5 ppm, and wherein the oxidative reductive potential water solution comprises one or more species selected from the group consisting of hypochlorous acid, hypochlorite ions, and combinations thereof.

42. A method of preventing systemic complications in a patient with peritonitis, the method comprising administering to the patient an oxidative reductive potential water solution in an amount effective to prevent peritoneal adhesions, wherein the solution is stable for at least about-two months, and the solution has a pH of from about 6.2 to about 7.8, a chlorine dioxide level that is less than about 5 ppm, and wherein the oxidative reductive potential water solution comprises one or more species selected from the group consisting of hypochlorous acid, hypochlorite ions, and combinations thereof.

43. The method of claim 42, wherein the systemic complications are selected from the group consisting of SIRS, sepsis, septic shock, and combinations thereof.