Antimicrobial activity of Citrox® bioflavonoid preparations against oral microorganisms

Hooper, Samuel James; Lewis, Michael Alexander Oxenham; Wilson, Matthew; Williams, David Wynne

doi:10.1038/sj.bdj.2010.1224

Cited by 34 publications

(38 citation statements)

References 38 publications

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“…The antistaphylococcal biofilm properties of Citrox are reported for the first time in this study. A previous study described the antimicro- bial properties of two formulations of Citrox versus oral microorganisms; while it demonstrated broad antimicrobial properties against a range of pathogens, that study did not include staphylococci and was limited to artificial in vitro planktonic and biofilm assays, which did not replicate the in vivo-like environment described in this study (11).…”

Section: Discussionmentioning

confidence: 99%

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Eradication of Staphylococcus aureus Catheter-Related Biofilm Infections Using ML:8 and Citrox

Hogan

Zapotoczna

Stevens

et al. 2016

Antimicrob Agents Chemother

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dStaphylococci are a leading cause of catheter-related infections (CRIs) due to biofilm formation. CRIs are typically managed by either device removal or systemic antibiotics, often in combination with catheter lock solutions (CLSs). CLSs provide high concentrations of the antimicrobial agent at the site of infection. However, the most effective CLSs against staphylococcal biofilmassociated infections have yet to be determined. The purpose of this study was to evaluate the efficacy and suitability of two newly described antimicrobial agents, ML:8 and Citrox, as CLSs against Staphylococcus aureus biofilms. ML:8 (1% [vol/vol]) and Citrox (1% [vol/vol]), containing caprylic acid and flavonoids, respectively, were used to treat S. aureus biofilms grown in vitro using newly described static and flow biofilm assays. Both agents reduced biofilm viability >97% after 24 h of treatment. Using a rat model of CRI, ML:8 was shown to inactivate early-stage S. aureus biofilms in vivo, while Citrox inactivated established, mature in vivo biofilms. Cytotoxicity and hemolytic activity of ML:8 and Citrox were equivalent to those of other commercially available CLSs. Neither ML:8 nor Citrox induced a cytokine response in human whole blood, and exposure of S. aureus to either agent for 90 days was not associated with any increase in resistance. Taken together, these data reveal the therapeutic potential of these agents for the treatment of S. aureus catheter-related biofilm infections.

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Section: Discussionmentioning

confidence: 99%

“…The flavonoids in Citrox are neoeriocitrin, isonaringin, naringin, hesperidin, neohesperidin, neodiosmin, naringenin, poncirin, and rhiofolin (10). The efficacy of Citrox against biofilm-producing oral microorganisms has been reported previously (11).…”

mentioning

confidence: 99%

Eradication of Staphylococcus aureus Catheter-Related Biofilm Infections Using ML:8 and Citrox

Hogan

Zapotoczna

Stevens

et al. 2016

Antimicrob Agents Chemother

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“…There is some evidence that whole plant extracts can have stronger biological effects than individual isolated compounds (15). Examples of such synergy include observations that the anti-malarial activity of artemisinin is enhanced by the presence of other compounds from the same plant (16,17) or the combination of flavonoids used in Citrox ® (15). Synergy may result from the presence of molecules which potentiate the activity of antimicrobial compounds, or from multiple active compounds with different mechanisms of action.…”

Section: Introductionmentioning

confidence: 99%

“…Conventional drug development calls for the isolation of single active compounds, whereas historical medicine usually calls for combinations of whole plants (and other natural materials). There is some evidence that whole plant extracts can have stronger biological effects than individual isolated compounds (15). Examples of such synergy include observations that the anti-malarial activity of artemisinin is enhanced by the presence of other compounds from the same plant (16,17) or the combination of flavonoids used in Citrox ® (15).…”

Section: Introductionmentioning

confidence: 99%

Anti-biofilm efficacy of a medieval treatment for bacterial infection requires the combination of multiple ingredients

Furner-Pardoe

Anonye

Cain

et al. 2020

Preprint

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Novel antimicrobials are urgently needed to combat the increasing occurrence of drug-resistant bacteria and to overcome the inherent difficulties in treating biofilm-associated infections. Research into natural antimicrobials could provide candidates to fill the antibiotic discovery gap, and the study of plants and other natural materials used in historical infection remedies may enable further discoveries of natural products with useful antimicrobial activity. We previously reconstructed a 1,000-year-old remedy containing onion, garlic, wine, and bile salts, which is known as ‘Bald’s eyesalve’, and showed it to have promising antibacterial activity. In this paper, we have found this remedy has bactericidal activity against a range of Gram-negative and Gram-positive wound pathogens in planktonic culture and, crucially, that this activity is maintained against Acinetobacter baumannii, Stenotrophomonas maltophilia, Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus pyogenes in a model of soft-tissue wound biofilm. While the presence of garlic in the mixture is sufficient to explain activity against planktonic cultures, garlic alone has no activity against biofilms. We have found the potent anti-biofilm activity of Bald’s eyesalve cannot be attributed to a single ingredient and requires the combination of all ingredients to achieve full activity. Our work highlights the need to explore not only single compounds but also mixtures of natural products for treating biofilm infections. These results also underline the importance of working with biofilm models when exploring natural products for the anti-biofilm pipeline.ImportanceBacteria can live in two ways, as individual planktonic cells or as a multicellular biofilm. Biofilm helps protect bacteria from antibiotics and makes them much harder to treat. Both the biofilm lifestyle and the evolution of antibiotic resistance mean we urgently need new drugs to treat infections. Here, we show that a medieval remedy made from onion, garlic, wine, and bile can kill a range of problematic bacteria grown both planktonically and as biofilms. A single component of the remedy – allicin, derived from garlic – is sufficient to kill planktonic bacteria. However, garlic or allicin alone do nothing against bacteria when they form a biofilm. All four ingredients are needed to fully kill bacterial biofilm communities, hinting that these ingredients work together to kill the bacteria. This suggests that future discovery of antibiotics from natural products could be enhanced by studying combinations of ingredients, rather than single plants or compounds.

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“…[24] Oral antimicrobial formulations whose active ingredients are soluble citrus bioflavonoids, for instance, are successfully commercialized. [25] Lemon flavonoids including the flavanones hesperidin (hesperetin 7-O-beta-rutinoside) and eriocitrin (eriodictyol 7-O-betarutinoside), and the flavone diosmin (diosmetin 7-O-rutinoside) exert numerous and different biological functions, including antioxidative, anti-inflammatory, antiviral, antiproliferative, antimutagenic, antiallergic, and anticarcinogenic activities. [26] Hesperidin and eriocitrin are chiefly contained in the albedo and in the flavedo and to a lesser extent in the pulp (levels in the albedo are 2-fold higher than in the flavedo, and 4-6-fold higher than the levels detected in pulp), whereas poorly soluble diosmin is almost entirely contained in the flavedo and in the albedo, [26] suggesting that waste lemon peel is an ideal source of these important biomolecules.…”

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confidence: 99%

Superior Antibacterial Activity of Integral Lemon Pectin From Hydrodynamic Cavitation

Presentato¹,

Scurria²,

Albanese³

et al. 2020

Preprint

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Pectin extracted via hydrodynamic cavitation in water only from waste lemon peel and further isolated via freeze drying displays significant antibacterial activity against Staphylococcus aureus, a Gram positive pathogen which easily contaminates food. The antibacterial effect of the new IntegroPectin is largely superior to that of commercial citrus pectin, opening the way to advanced applications of a new bioproduct now obtainable in large amounts and at low cost from citrus juice industry’s waste.

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Antimicrobial activity of Citrox® bioflavonoid preparations against oral microorganisms

Cited by 34 publications

References 38 publications

Eradication of Staphylococcus aureus Catheter-Related Biofilm Infections Using ML:8 and Citrox

Eradication of Staphylococcus aureus Catheter-Related Biofilm Infections Using ML:8 and Citrox

Anti-biofilm efficacy of a medieval treatment for bacterial infection requires the combination of multiple ingredients

Superior Antibacterial Activity of Integral Lemon Pectin From Hydrodynamic Cavitation

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