Editors' ChoiceANTISEPTICS

A cage for pathogens

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Science Translational Medicine  23 Mar 2016:
Vol. 8, Issue 331, pp. 331ec49
DOI: 10.1126/scitranslmed.aaf6418

Since ancient times, antiseptic agents such as wine and vinegar have been used to treat wounds and fight infection. Modern antiseptics are employed liberally both for prophylactic and therapeutic purposes, and total consumption in the United States amounts to a staggering 20 million liters annually. Although there are 29 antiseptic agents currently recognized by the FDA, only seven are used in distributed healthcare products. Many of these products are now in jeopardy following a May 2015 FDA report indicating that the active ingredients can no longer be classified as "generally recognized as safe," or GRAS. Furthermore, even the most powerful antiseptics used in hospitals today have been rendered impotent to drug-resistant bacteria. As such, there is an urgent need for new antiseptics with broad-spectrum antimicrobial activity, especially against drug-resistant pathogens.

Zakrewsky and colleagues have now demonstrated the potential of a choline and geranate (CAGE) solvent in wiping out a broad array of infections. None of the 47 unique microbial strains examined in this study survived when challenged with CAGE, including the bacteria Mycobacterium tuberculosis and Staphylococcus aureus (commonly known as MRSA); the fungus Candida albicans; and the herpes simplex virus types 1 and 2. In contrast to currently approved antiseptics, CAGE did not damage human skin cells at the concentrations required for bactericidal activity. Although the mechanism of action is unclear, it is speculated that CAGE preferentially disrupts the lipid membranes of microbes compared with mammalian cells. CAGE was also effective in a rat acne model that harbored a Propionibacterium acnes infection. Topical treatment with CAGE significantly improved outcomes compared with the standard prescription for acne, 1% w/v clindamycin.

Together with a previous report demonstrating potency against biofilms, these data suggest that CAGE may fill a gaping hole in the vulnerable world of antiseptics. Future work is needed to confirm antimicrobial efficacy and safety on human skin and to assess the propensity of pathogens to develop resistance to CAGE after repeated exposure.

M. Zakrewsky et al., Choline and geranate deep eutectic solvent as a broad-spectrum antiseptic agent for preventive and therapeutic applications. Adv. Healthcare Mater. 10.1002/adhm.201600086 (2016). [Abstract]

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