Increased expression of glucagon-like peptide-1 and cystic fibrosis transmembrane conductance regulator in the ileum and colon in mouse treated with metformin.

Metformin, an oral medication, is prescribed to patients with type 2 diabetes mellitus. Although the efficacy, safety, and low economic burden of metformin on patients have long been recognized, approximately 5% of the patients treated with this drug develop severe diarrhea and discontinue the treatment. We previously reported that 1,000 mg·kg-1·day-1 of metformin induced diarrhea in diabetic obese (db/db) mice and wood creosote (traditional medication for diarrhea) ameliorated the symptoms. In this study, we attempted to elucidate the molecular mechanisms by which metformin induces diarrhea. Cystic fibrosis transmembrane conductance regulator (CFTR) is a key ion (chloride) channel in cyclic adenosine monophosphate (cAMP)-induced diarrhea. Metformin treatment increased bile flow (bile acids and bilirubin) in the ileum of mice. In addition, the treatment was accompanied by an increase in mRNA and protein levels of CFTR in the mucosa of the ileum and colon in both wild-type (C57BL/6J) and db/db mice. Glucagon-like peptide-1 (GLP-1), as well as cholic acid, induces CFTR mRNA expression in human colon carcinoma Caco-2 cells through cAMP signaling. Although wood creosote (10 mg/kg) ameliorated diarrhea symptoms, it did not alter the mRNA levels of Glp-1 or Cftr. Similar to overeating, metformin upregulated GLP-1 and CFTR expression, which may have contributed to diarrhea symptoms in mice. Although we could not identify db/db mouse-specific factors associated with metformin-induced diarrhea, these factors may modulate colon function. Wood creosote may not interact with these factors but ameliorates diarrhea symptoms.

Evaluation of the antiviral activity of chlorine dioxide and sodium hypochlorite against feline calicivirus, human influenza virus, measles virus, canine distemper virus, human herpesvirus, human adenovirus, canine adenovirus and canine parvovirus.

We evaluated the antiviral activity of a chlorine dioxide gas solution (CD) and sodium hypochlorite (SH) against feline calicivirus, human influenza virus, measles virus, canine distemper virus, human herpesvirus, human adenovirus, canine adenovirus and canine parvovirus. CD at concentrations ranging from 1 to 100 ppm produced potent antiviral activity, inactivating >or= 99.9% of the viruses with a 15 sec treatment for sensitization. The antiviral activity of CD was approximately 10 times higher than that of SH.

Effect of extremely low-concentration gaseous chlorine dioxide against surface Escherichia coli, Pseudomonas aeruginosa and Acinetobacter baumannii in wet conditions on glass dishes.

OBJECTIVE: Healthcare-associated infections due to Gram-negative bacteria (GNB) are a major cause of mortality and morbidity throughout the world. The purpose of the research described here was to evaluate the possibility of using an extremely low-concentration gaseous chlorine dioxide (ClO2, 0.01 ppmv, 0.028 mg/m3) as a technique to reduce the risk of environmental infection by GNB. In this study we set up an exposure chamber (1 m3) and used three types of GNB, namely Escherichia coli, Pseudomonas aeruginosa and Acinetobacter baumannii. RESULTS: The extremely low-concentration gaseous ClO2 inactivated E. coli (> 2 log10 reductions, within 2 h), P. aeruginosa (> 4 log10 reductions, within 2 h) and A. baumannii (> 2 log10 reductions, within 3 h) in wet conditions on glass dishes. Treatment of moist environments with extremely low-concentration gaseous ClO2 may help to reduce the risk of environmental infection by GNB without harmful effects.

Mouse model of metformin-induced diarrhea.

OBJECTIVE: Metformin, an oral medication used for type 2 diabetes mellitus, is the most commonly prescribed drug with less economic burden of patients. Although metformin's efficacy and safety have long been recognized, approximately 5% of the patients treated with this drug develop severe diarrhea as an adverse effect and have to abandon treatment. Because there is no animal model to study metformin-induced diarrhea, it is hard to develop methods to maintain quality of life of patients prescribed with metformin. RESEARCH DESIGN AND METHODS: Using mouse models, we tried to develop an evaluation system for metformin-induced diarrhea to improve diarrheal symptoms in patients with diabetes. Healthy (C57BL/6J) and diabetic obese (db/db) mice were subjected to a stepwise dose escalation of metformin (250 mg/kg/day (125 mg/kg twice daily oral dose)-1000 mg/kg/day (500 mg/kg twice daily oral dose)), and fecal moisture contents and their score were monitored. To evaluate anti-diarrheal medications, wood creosote (a traditional medicine) was tested. Several groups of enterobacteria in fresh feces were examined by using PCR. RESULTS: 1000 mg/kg/day (four times maximal effective dose) of metformin significantly increased fecal moisture content. Although no symptoms of diarrhea were observed in healthy C57BL/6J mice, the same dose of metformin induced severe diarrhea in diabetic obese db/db mice. A reduction in PCR signals for the Firmicutes group was associated with metformin-induced diarrhea. Wood creosote reduced diarrhea (high water-content) without affecting metformin's efficacy or enterobacterial flora levels. CONCLUSIONS: We have created the first animal model of metformin-induced diarrhea using db/db mice, which will provide better quality of life for patients suffering from diarrhea caused by metformin.

Inactivation of feline calicivirus, a norovirus surrogate, by chlorine dioxide gas.

The efficacy of gaseous chlorine dioxide (ClO2) against feline calicivirus (FCV), a norovirus surrogate, in the dry and the wet states on a hard surface was evaluated. We demonstrated that low-concentration ClO2 gas (mean 0.08 ppm, 0.22 microg/I) could inactivate FCV in the wet state with 0.5% fetal bovine serum (FBS) within 6 h in 45 to 55% relative humidity (RH) (> 3 log10 reductions) and FCV in the dry state with 2% FBS (percentage of FBS in the viral suspension) within 10 h in 75 to 85% RH (> 3 log10 reductions) at 20 degrees C, respectively. Furthermore, a < 0.3 ppm concentration of ClO2 gas (mean 0.26 ppm, 0.73 microg/l) could inactivate (below the detection limit) FCV in the dry state with 5% FBS within 24 h in 75 to 85% RH at 20 degrees C. In contrast, in 45 to 55% RH at 20 degrees C, ClO2 gas had little effect even when the FCV in the dry state was exposed to high-concentration ClO2 (mean 8 ppm, 22.4 microg/l) for 24 h. These results suggest that humidity plays an important role in the inactivation by ClO2 gas of FCV in the dry state. According to the International Chemical Safety Card, threshold limit values for ClO2 gas are 0.1 ppm as an 8-h time-weighted average and 0.3 ppm as a 15 min short-term exposure limit. From these data, we propose that the treatment of wet areas of human activity such as kitchens, toilets, etc., with low-concentration ClO2 gas would be useful for reducing the risk of infection by noroviruses (NV) without adverse effects. In addition, we believe that the application of a combination of a < 0.3 ppm concentration of ClO2 gas and a humidifier in places without human activity may make it possible to inactivate NV in the dry state on any surface within a contaminated room without serious adverse effects.

[Inhibition of hyphal growth of the fungus Alternaria alternata by chlorine dioxide gas at very low concentrations].

The efficacy of chlorine dioxide (ClO(2)) gas at very low concentrations for hyphal growth of Alternaria alternata related to fungal allergy was evaluated using a fungus detector. The fungus detector is a plastic sheet with a drop of spore-suspending medium, and it makes possible clear observations of hyphal growth with a light microscope. ClO(2) gas (average 0.075 ppm, 0.21 microg/l) inhibited hyphal growth of the fungus, but not germination of fungal spores. The hyphal length was more than 1780 mum under air conditions (control) and 49+/-17 microm under ClO(2) gas conditions for 72 h. According to the international chemical safety card, threshold limit values for ClO(2) gas are 0.1 ppm as an 8-h time-weight average and 0.3 ppm as a 15 min short-term exposure limit. From these data, we propose that treatment with ClO(2) gas at very low concentrations in space is a useful tool for the growth inhibition of fungi in the fields of food, medicine, etc. without adverse effects.

Chlorine Dioxide is a Better Disinfectant than Sodium Hypochlorite against Multi-Drug Resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii.

In this study, we evaluated and compared the antibacterial activity of chlorine dioxide (ClO2) and sodium hypochlorite (NaClO) on various multidrug-resistant strains in the presence of bovine serum albumin and sheep erythrocytes to mimic the blood contamination that frequently occurs in the clinical setting. The 3 most important species that cause nosocomial infections, i.e., methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Pseudomonas aeruginosa (MDRP), and multidrug-resistant Acinetobacter baumannii (MDRA), were evaluated, with three representative strains of each. At a 10-ppm concentration, ClO2 drastically reduced the number of bacteria of all MDRP and MDRA strains, and 2 out of 3 MRSA strains. However, 10 ppm of NaClO did not significantly kill any of the 9 strains tested in 60 seconds (s). In addition, 100 ppm of ClO2 completely killed all MRSA strains, whereas 100 ppm of NaClO failed to significantly lower the number of 2 MRSA strains and 1 MDRA strain. A time-course experiment demonstrated that, within 15 s, 100 ppm of ClO2, but not 100 ppm of NaClO, completely killed all tested strains. Taken together, these data suggest that ClO2 is more effective than NaClO against MRSA, MDRP, and MDRA, and 100 ppm is an effective concentration against these multidrug-resistant strains, which cause fatal nosocomial infections.

[Inactivation of feline calicivirus by chlorine dioxide gas-generating gel].

Noroviruses are one of the most important causes of acute gastroenteritis throughout the world. The aim of this study is to evaluate the efficacy of a chlorine dioxide gas-generating gel (ClO2 gel, 60 g) against feline calicivirus (FCV), a norovirus surrogate, in the wet state on glass dishes in a test sink (43 cm long, 75 cm wide, and 29 cm deep). The ClO2 gel permits sustained release of gaseous ClO2 (1.7 mg/h at 25°C), and was placed in one corner of the test sink. The glass dishes containing FCV suspension were placed at three positions in the test sink. We demonstrated that FCV was inactivated within 5h (>2 or >3 log10 reductions at three positions, n=20) in the test sink where the ClO2 gel was placed. These small quantities of ClO2 gel might be a useful tool for reducing the risk of infection by norovirus in wet environments such as kitchens and bathrooms under optimal condition.

Six-month low level chlorine dioxide gas inhalation toxicity study with two-week recovery period in rats.

BACKGROUND: Chlorine dioxide (CD) gas has a potent antimicrobial activity at extremely low concentration and may serve as a new tool for infection control occupationally as well as publicly. However, it remains unknown whether the chronic exposure of CD gas concentration effective against microbes is safe. Therefore, long-term, low concentration CD gas inhalation toxicity was studied in rats as a six-month continuous whole-body exposure followed by a two-week recovery period, so as to prove that the CD gas exposed up to 0.1 ppm (volume ratio) is judged as safe on the basis of a battery of toxicological examinations. METHODS: CD gas at 0.05 ppm or 0.1 ppm for 24 hours/day and 7 days/week was exposed to rats for 6 months under an unrestrained condition with free access to chow and water in a chamber so as to simulate the ordinary lifestyle in human. The control animals were exposed to air only. During the study period, the body weight as well as the food and water consumptions were recorded. After the 6-month exposure and the 2-week recovery period, animals were sacrificed and a battery of toxicological examinations, including biochemistry, hematology, necropsy, organ weights and histopathology, were performed. RESULTS: Well regulated levels of CD gas were exposed throughout the chamber over the entire study period. No CD gas-related toxicity sign was observed during the whole study period. No significant difference was observed in body weight gain, food and water consumptions, and relative organ weight. In biochemistry and hematology examinations, changes did not appear to be related to CD gas toxicity. In necropsy and histopathology, no CD gas-related toxicity was observed even in expected target respiratory organs. CONCLUSIONS: CD gas up to 0.1 ppm, exceeding the level effective against microbes, exposed to whole body in rats continuously for six months was not toxic, under a condition simulating the conventional lifestyle in human.

Wood creosote inhibits calcium mobilization in Guinea pig colonic smooth muscle.

Wood creosote, a mixture of simple phenolic compounds, has long been used as an herbal antidiarrheal medicine. Previous studies have shown that wood creosote has antimotility activity on the gastrointestinal (GI) tract, although its mechanism of action is not completely understood. The in vitro efficacy of wood creosote on calcium mobilization in guinea pig colonic smooth muscle was evaluated using a digital video camera system mounted on an inverted fluorescence microscope. The effects of wood creosote on spontaneous periodic increases in the free cytosolic calcium concentration ([Ca(2+)](i)), acetylcholine (ACh)-enhanced periodic increases in [Ca(2+)](i), and tetrodotoxin- or nifedipine-resistant spontaneous periodic increases in [Ca(2+)](i) were evaluated. Wood creosote decreased the amplitude of spontaneous (IC(50)=21 microg/ml) and ACh-enhanced (IC(50)=40 microg/ml) periodic increases in [Ca(2+)](i) in guinea pig colonic smooth muscle. Wood creosote also decreased the amplitude of both tetrodotoxin- and nifedipine-resistant spontaneous periodic increases in [Ca(2+)](i). These results suggest that antimotility activity through inhibition of Ca(2+) mobilization in the GI tract is at least partially responsible for the antidiarrheal activity of wood creosote. Wood creosote may exert its antimotility effect, at least in part, on network regions of interstitial cells of Cajal, which act as pacemaker cells and mediators of neurotransmission in the GI tract.