Innovative cold atmospheric plasma (iCAP) decreases corneal ulcer formation and bacterial loads and improves anterior chamber health in methicillin resistant Staphylococcus aureus keratitis.

Bacterial keratitis is a vision-threatening infection of the cornea that is typically treated with antibiotics. However, antibiotics sometimes fail to eradicate the infection and do not prevent or repair the damage caused directly by the bacteria or the host immune response to the infection. Our group previously demonstrated that treatment of Pseudomonas aeruginosa keratitis in rabbits with innovative cold atmospheric plasma (iCAP) resulted in reduced edema, ulcer formation, and bacterial load. In this study, we investigated the efficacy of iCAP treatment in methicillin-resistant Staphylococcus aureus (MRSA). New Zealand white rabbits were infected intrastromally with MRSA then treated with iCAP, moxifloxacin, vancomycin, or combination of iCAP with each antibiotic to assess the safety and efficacy of iCAP treatment compared to untreated controls and antibiotics. iCAP treatment significantly reduced bacterial loads and inflammation, improved anterior chamber clarity, and prevented corneal ulceration compared to untreated controls and antibiotic treatment. Safety assessments of grimace test scores and tear production showed that iCAP was not significantly different from either antibiotic treatment in terms of distress or tear production. Combination iCAP/antibiotic treatment did not appear to provide significant added benefit over iCAP alone. Our findings suggest that the addition of iCAP may be a viable tool in reducing damage to the cornea and anterior chamber of the eye following S. aureus keratitis.

Innovative Cold Atmospheric Plasma (iCAP) Decreases Mucopurulent Corneal Ulcer Formation and Edema and Reduces Bacterial Load in Pseudomonas Keratitis.

PURPOSE: To evaluate the effect of application of 3% air in helium cold atmospheric plasma jet, using an inexpensive device termed iCAP, in corneal scratch wound closure in vitro and the treatment of Pseudomonas aeruginosa (P. aeruginosa) keratitis in vivo. METHODS: Thermal imaging to measure temperature of surfaces to which iCAP was applied and UV energy density delivered by iCAP were measured. Scratch wounds inflicted on in vitro cultures of a human corneal epithelial cell line were treated with iCAP and wound widths at various times post-application were measured. Rabbit eyes infected with P. aeruginosa were treated with iCAP and slit lamp biomicroscope examination conducted to determine corneal health outcomes 25h post infection. Corneal homogenates were plated on agar and viable bacterial colonies enumerated to determine the effect of iCAP on bacterial load in vivo in P. aeruginosa keratitis. RESULTS: iCAP was shown to operate in the non-thermal regime and also shown to deliver much lower UV energy density than that necessary to cause harmful effects on ocular tissue. iCAP treatment significantly improved the rate of scratch wound gap closure in vitro in a human corneal epithelial cell line compared to controls. In vivo, iCAP treatment of P. aeruginosa keratitis infection in the rabbit eyes (N = 20) significantly reduced the incidence of corneal ulcer (P = 0.003) and corneal edema (P = 0.011) and significantly improved total cornea health (P = 0.034) compared to untreated (N = 10). Finally, in vivo iCAP treatment of P. aeruginosa keratitis infection in the rabbit eyes (N = 19) significantly reduced bacterial loads (P = 0.012) compared to untreated (N = 9). CONCLUSION: Our results strongly suggest that iCAP treatment was effective in improving corneal epithelial defect closure in vitro, reducing ulcer formation and decreasing inflammation in P. aeruginosa infected corneas in vivo and decreasing bacterial loads in P. aeruginosa infected corneas in vivo which led to improved overall cornea health outcomes in vivo. Further studies to investigate iCAP's safety and efficacy against other infectious microbes responsible for causing ulcerative keratitis, with and without co-treatment with antimicrobial therapies are warranted.

Antibody functionalized graphene biosensor for label-free electrochemical immunosensing of fibrinogen, an indicator of trauma induced coagulopathy.

An antibody, specific to fibrinogen, has been covalently attached to graphene and deposited onto screen printed electrodes using a chitosan hydrogel binder to prepare an inexpensive electrochemical fibrinogen biosensor. Fourier Transform Infrared (FT-IR) spectroscopy has been utilized to confirm the presence of the antibody on the graphene scaffold. Electrochemical Impedance Spectroscopy (EIS) has been utilized to demonstrate that the biosensor responds in a selective manner to fibrinogen in aqueous media even in the presence of plasminogen, a potentially interfering molecule in the coagulopathy cascade. Furthermore, the biosensor was shown to reliably sense fibrinogen in the presence of high background serum albumin levels. Finally, we demonstrated detection of clinically relevant fibrinogen concentrations (938-44,542µg/dL) from human serum and human whole blood samples using this biosensor. This biosensor can potentially be used in a point-of-care device to detect the onset of coagulopathy and monitor response following therapeutic intervention in trauma patients. Thus this biosensor may improve the clinical management of patients with trauma-induced coagulopathy.

A general photonic crystal sensing motif: creatinine in bodily fluids.

We developed a new sensing motif for the detection and quantification of creatinine, which is an important small molecule marker of renal dysfunction. This novel sensor motif is based on our intelligent polymerized crystalline colloidal array (IPCCA) materials, in which a three-dimensional crystalline colloidal array (CCA) of monodisperse, highly charged polystyrene latex particles are polymerized within lightly cross-linked polyacrylamide hydrogels. These composite hydrogels are photonic crystals in which the embedded CCA diffracts visible light and appears intensely colored. Volume phase transitions of the hydrogel cause changes in the CCA lattice spacings which change the diffracted wavelength of light. We functionalized the hydrogel with two coupled recognition modules, a creatinine deiminase (CD) enzyme and a 2-nitrophenol (2NPh) titrating group. Creatinine within the gel is rapidly hydrolyzed by the CD enzyme in a reaction which releases OH(-). This elevates the steady-state pH within the hydrogel as compared to the exterior solution. In response, the 2NPh is deprotonated. The increased solubility of the phenolate species as compared to that of the neutral phenols causes a hydrogel swelling which red-shifts the IPCCA diffraction. This photonic crystal IPCCA senses physiologically relevant creatinine levels, with a detection limit of 6 microM, at physiological pH and salinity. This sensor also determines physiological levels of creatinine in human blood serum samples. This sensing technology platform is quite general. It may be used to fabricate photonic crystal sensors for any species for which there exists an enzyme which catalyzes it to release H(+) or OH(-).

High ionic strength glucose-sensing photonic crystal.

We demonstrate a colorimetric glucose recognition material consisting of a crystalline colloidal array embedded within a polyacrylamide-poly(ethylene glycol) (PEG) hydrogel, or a polyacrylamide-15-crown-5 hydrogel, with pendent phenylboronic acid groups. We utilize a new molecular recognition motif, in which boronic acid and PEG (or crown ether) functional groups are prepositioned in a photonic crystal hydrogel, such that glucose self-assembles these functional groups into a supramolecular complex. The formation of the complex results in an increase in the hydrogel cross-linking, which for physiologically relevant glucose concentration blue shifts the photonic crystal diffraction. The visually evident diffraction color shifts across the visible spectral region over physiologically important glucose concentration ranges. These materials respond to glucose at physiological ionic strengths and pH values and are selective in their mode of response for glucose over galactose, mannose, and fructose. Thus, we have developed a new recognition motif for glucose that shows promise for the fabrication of noninvasive or minimally invasive in vivo glucose sensing for patients with diabetes mellitus.

Photonic crystal aqueous metal cation sensing materials.

We developed a polymerized crystalline colloidal array photonic material that senses metal cations in water at low concentrations (PCCACS). Metal cations such as Cu2+, Co2+, Ni2+, and Zn2+ bind to 8-hydroxyquinoline groups covalently attached to the PCCACS. At low metal concentrations (

Photonic crystal carbohydrate sensors: low ionic strength sugar sensing.

We developed a carbohydrate sensing material, which consists of a crystalline colloidal array (CCA) incorporated into a polyacrylamide hydrogel (PCCA) with pendent boronic acid groups. The embedded CCA diffracts visible light, and the PCCA diffraction wavelength reports on the hydrogel volume. This boronic acid PCCA responds to species containing vicinal cis diols such as carbohydrates. This PCCA photonic crystal sensing material responds to glucose in low ionic strength aqueous solutions by swelling and red shifting its diffraction as the glucose concentration increases. The hydrogel swelling results from a Donnan potential due to formation of boronate anion; the boronic acid pK(a) decreases upon glucose binding. This sensing material responds to glucose and other sugars at <50 microM concentrations in low ionic strength solutions.