Vanda Haralovi´c 1 , Mislav Mokos 1 , Sanja Špoljar 1 , Lorena Dolaˇcki 2 , Mirna Šitum 1,2 and Liborija Lugovi´c-Mihi´c 1,2,*
1Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, Vinogradska cesta 29, 10000 Zagreb, Croatia; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (V.H.)
2School of Dental Medicine, University of Zagreb, Gunduli´ceva 5, 10000 Zagreb, Croatia
*Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。; Tel.:+385-(01)-3787-111
Abstract
Background: Hypochlorous acid (HOCl) is an integral component of the human innate immune system. It possesses antimicrobial properties and is available in solution, dermal spray, and scar gel forms. Objectives/Methods: This review presents data from studies on the clinical use of HOCl in various specialties, including der-matology, surgery, dentistry, ophthalmology, and rhinology. Results: Due to its antiinflammatory/antimicrobial/immunomodulatory and healing properties, HOCl is advantageous in treating various skin disorders: ulcus cruris (and wound care), diabetic ulcers, atopic dermatitis, seborrheic dermatitis, pruritus, acne vulgaris, etc. Also, the application of a HOCl spray/gel after surgical procedures may prevent infection, reduce inflammation, and accelerate healing. HOCl is also effective and safe for the prevention and treatment of hypertrophic and keloid scars. Growing evidence shows a broader role for HOCl in limiting cancer cell survival and slowing tumor growth. It is also important in treating various viral infections like SARS-CoV-2 (coronavirus), influenza, and herpes, thereby helping to prevent the spread of aerosols. In addition, since HOCl is an endogenous compound naturally present in mammals with a high safety profile, it may be an effective bacterial disinfectant in dental waterlines. In ophthalmology, adjuvant treatment with HOCl ophthalmic spray can reduce the duration of antibiotic/corticosteroid use, even in severe blepharitis. To fully harness the protective/therapeutic properties of HOCl, future advancements will rely on the development of new chemical compounds and sophisticated pharmaceutical formulations.Conclusions: The majority of clinical studies have confirmed that HOC1 is useful in therapy, although the results are not entirely consistent. Further research is essential to optimize HOCl dosing and to develop controlled-release systems aimed at maximizing its anti-inflammatory and photoprotective effects while minimizing tissue irritation and damage.
Keywords: topical treatment; antimicrobial therapy; anti-inflammatory drugs; immunomodulator; healing; ulcer; atopic dermatitis; surgical procedures; postoperative care; disinfectant
Xiaolong A. Zhou1 | Michael B. Burns2 | Ziyou Ren1 | Elise Stagaman2 | Stefan J. Green3 | Lok Yiu Ashley Wu3 | Lynna Yang1 | Stephanie Rangel1 | Lydia Rabbaa1 | Amy S. Paller1
1Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA | 2Department of Biology, Loyola University Chicago, Chicago, Illinois, USA | 3Genomics and Microbiome Core Facility, Rush University Medical Center, Chicago, Illinois, USA
Correspondence: Amy S. Paller (该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)
Received: 6 February 2025 | Revised: 6 June 2025 | Accepted: 3 August 2025
Funding: This work was supported by Applied Pharma Research.
Keywords: acid-oxidising solution | epidermolysis bullosa | hypochlorous acid | microbiome | Staphylococcus aureus | wounds
ABSTRACT
Epidermolysis bullosa (EB) is a group of rare genetic skin disorders characterised by skin fragility and chronic, painful wounds that are highly susceptible to bacterial infection, particularly by Staphylococcus aureus (SA). This study evaluated the efficacy of an acid-oxidising solution containing hypochlorous acid (HOCl) in reducing SA colonisation, promoting wound healing, and restoring a healthier microbiome in EB wounds. In a 12-week open-label pilot study, 15EB patients applied the HOCl-based spray (APR-TD011) daily to chronic wounds for 8weeks, with full-length 16S rRNA sequencing of wound swabs performed before, during, and after treatment. At baseline, 87% of patients were culture-positive for SA, and sequencing revealed that SA had the highest relative abundance (34%), followed by Acinetobacter guillouiae and Pseudomonas poae. SA relative abundance decreased precipitously by Weeks 4 (to 11%) and 8 (primary endpoint; to 10%, p<0.01), and this effect persisted at 4weeks post-treatment (Week 12; to 9.7%), including for methicillin-resistant SA. Concurrently, bacterial diversity increased, and wound sizes dimin ished in correlation with reduced SA levels (r=0.64). Younger patients exhibited greater SA reduction trends. The treatment was well-tolerated, with minimal adverse effects and high patient satisfaction. This study underscores the role of microbial dysbiosis in EB wounds and highlights HOCl-based solutions as a promising therapy to mitigate pathogenic burden and enhance wound.
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伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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