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Cytotoxicity to human leukocytes by topical antimicrobial agents used for burn care
R L Zapata-Sirvent1, J F Hansbrough
1Department of Surgery University of California, San Diego Medical Center 92103.
Abstract:
We tested two topical antimicrobial agents (TAAs), silver sulfadiazine and mafenide acetate, to determine their cytotoxic effects when human lymphocytes and neutrophils were incubated with the agents in vitro for 30 minutes. Dilute concentrations of both TAAs markedly inhibited neutrophil respiratory burst activity and mitogen-stimulated lymphocyte proliferation (p < 0.05). The components of silver sulfadiazine (silver and sulfadiazine) were separately tested, and each component inhibited both neutrophil and lymphocyte functions. Mafenide acetate markedly decreased intracellular Ca+2 flux in lymphocytes. The effects of the TAAs were partially reversed when cells were washed and resuspended in medium after they were exposed in vitro to the TAAs. Commonly used TAAs may contribute to local immune dysfunction in the patient with burns. Because evidence suggests that T lymphocytes may participate in wound healing, prolonged treatment with TAAs may also effect certain aspects of wound healing.
Insights
Topical antimicrobial agents like silver sulfadiazine and mafenide acetate can impair immune cell function. These agents may negatively impact wound healing by inhibiting neutrophil and lymphocyte activity.
Area of Science:
- Immunology
- Dermatology
- Pharmacology
Background:
- Topical antimicrobial agents (TAAs) are frequently used in burn wound management.
- The potential impact of TAAs on local immune cell function is not fully understood.
Purpose of the Study:
- To investigate the in vitro cytotoxic effects of silver sulfadiazine and mafenide acetate on human lymphocytes and neutrophils.
- To determine if individual components of silver sulfadiazine contribute to cytotoxicity.
Main Methods:
- Human lymphocytes and neutrophils were incubated with varying concentrations of silver sulfadiazine and mafenide acetate for 30 minutes.
- Neutrophil respiratory burst activity and lymphocyte proliferation were measured.
- Intracellular calcium ion (Ca+2) flux in lymphocytes was assessed.
- Effects were evaluated after washing and resuspending cells.
Main Results:
- Both silver sulfadiazine and mafenide acetate significantly inhibited neutrophil respiratory burst activity and lymphocyte proliferation at dilute concentrations.
- Individual components of silver sulfadiazine (silver and sulfadiazine) also demonstrated inhibitory effects on both cell types.
- Mafenide acetate significantly reduced intracellular Ca+2 flux in lymphocytes.
- Observed effects were partially reversible upon removal of the TAAs.
Conclusions:
- Commonly used TAAs can induce local immune dysfunction by inhibiting key immune cell functions.
- Prolonged TAA treatment may adversely affect wound healing processes, potentially due to T-lymphocyte involvement.
- Further research is warranted to explore the long-term implications of TAAs on burn wound recovery.