Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Department of Perioperative Functioning Care and Support, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
PLoS One. 2024 Nov 12;19(11):e0311552. doi: 10.1371/journal.pone.0311552. eCollection 2024.
Far ultraviolet-C irradiation at 222 nm has potent bactericidal effects against severe infections such as peritonitis, with minimal cytotoxicity. Bacterial peritonitis due to bowel perforation is a serious condition with high mortality despite current treatments. This study investigated the safety and efficacy of intraperitoneal far ultraviolet-C irradiation at 222 nm. In vitro experiments optimized the fluid conditions for bacterial or protein concentrations prior to in vivo evaluation. In vivo efficacy was assessed in a rat peritonitis model induced by Escherichia coli, measuring intra-abdominal bacterial concentration, blood cytokine levels, and mortality rates. Safety was evaluated by analyzing cyclobutane pyrimidine dimers as markers of DNA damage in five abdominal organs: stomach, small intestine, colon, liver, and spleen. Statistical analyses employed parametric methods for normally distributed data and non-parametric methods for data without normality. Optimal in vitro conditions included 106 CFU/mL bacteria, 0.5 mW/cm2 irradiation, and 10-3 mg/mL protein. In the rat model, far ultraviolet-C irradiation at 222 nm significantly decreased intra-abdominal bacteria, reduced blood cytokines (interleukin-1β and interleukin-6), and elevated survival rates from 20% to 60%, compared to lavage alone. The formation of cyclobutane pyrimidine dimers was significantly lower with 222 nm irradiation than with 254 nm, suggesting reduced DNA damage. These findings indicate that far ultraviolet-C irradiation at 222 nm, when combined with lavage, represents a promising therapeutic strategy for bacterial peritonitis, providing effective bacterial reduction and a favorable safety profile. Further research is needed to verify these findings and investigate long-term safety and potential clinical applications.
222nm 远紫外线 C 照射对腹膜炎等严重感染具有强大的杀菌作用,细胞毒性极小。尽管目前有治疗方法,但由于肠穿孔引起的细菌性腹膜炎仍然是一种死亡率很高的严重疾病。本研究调查了 222nm 腹腔内远紫外线 C 照射的安全性和疗效。在体内评估之前,通过体外实验优化了细菌或蛋白质浓度的流体条件。通过大肠杆菌诱导的大鼠腹膜炎模型评估体内疗效,测量腹腔内细菌浓度、血液细胞因子水平和死亡率。通过分析五种腹部器官(胃、小肠、结肠、肝和脾)中的 DNA 损伤标志物环丁烷嘧啶二聚体来评估安全性。统计分析采用正态分布数据的参数方法和无正态性数据的非参数方法。最佳的体外条件包括 106 CFU/mL 细菌、0.5mW/cm2 照射和 10-3mg/mL 蛋白质。在大鼠模型中,与单纯冲洗相比,222nm 远紫外线 C 照射显著降低了腹腔内细菌数量,降低了血液细胞因子(白细胞介素-1β和白细胞介素-6)水平,将存活率从 20%提高到 60%。与 254nm 相比,222nm 照射形成的环丁烷嘧啶二聚体明显减少,表明 DNA 损伤减少。这些发现表明,222nm 远紫外线 C 照射与冲洗相结合,为细菌性腹膜炎提供了一种有前途的治疗策略,具有有效的细菌减少和良好的安全性。需要进一步研究来验证这些发现,并研究长期安全性和潜在的临床应用。