Nitric Oxide solution for Tinea Pedis

NewsBot · Oct 23, 2012

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A Nitric Oxide Releasing Solution as a Potential Treatment for Fungi Associated with Tinea Pedis.
Regev-Shoshani G, Crowe A, Miller CC.
J Appl Microbiol. 2012 Oct 22.

AIMS:
To test a nitric oxide releasing solution (NORS) as a potential antifungal footbath therapy against T. mentagrophytes and T. rubrum during the mycelial and conidial phases.

METHODS AND RESULTS:
NORS (sodium nitrite citric acid) produces nitric oxide verified by gas chromatography and mass spectrometry (GC-MS). Antifungal activity of this solution was tested against mycelia and conidia of T. mentagrophytes and T. rubrum, using 1-20 mmole l(-1) nitrites and 10-30 min exposure times. The direct effect of the gas released from the solution on the viability of those fungi was tested. NORS demonstrated strong antifungal activity and was found to be dose and time dependent. NO and nitrogen dioxide (NO(2) ) were the only gases detected from this reaction and are likely responsible for the antifungal effect.

CONCLUSION:
This in vitro research suggests that a single 20 minute exposure to NORS, could potentially be used as an effective single dose treatment against fungi that are associated with tinea pedis in both mycelia and spore phase.

SIGNIFICANCE AND IMPACT OF STUDY:
This study provides the background for developing a user friendly footbath treatment for Athlete's Foot that will kill both vegetative fungi and its spores
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Admin2 · Oct 23, 2012

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Trial of nitric oxide patch in diabetic foot ulcers

NewsBot · Aug 21, 2018

A Phase 2, Controlled, Dose-Ranging Study of SB208, an Investigational Topical Nitric Oxide-Releasing Drug, for the Treatment of Tinea Pedis.
Elewski BE, Kircik LH, Stasko N, De Leon E, Enloe C, Durham T, Maeda-Chubachi T.
J Drugs Dermatol. 2018 Aug 1;17(8):888-893.

BACKGROUND:
Tinea pedis, or athlete's foot, is a superficial, skin infection caused by dermatophytes. It is usually topically treated. Nitric oxide is endogenously produced in humans and has a variety of physiologic and antimicrobial properties. SB208 is a novel topical treatment comprising berdazimer sodium (a nitric oxide-storing macromolecule) and a hydrogel. Admixing these two components releases nitric oxide to the application site.

METHODS:
A phase 2, double-blind, randomized trial evaluated the safety and efficacy of 3 doses of SB208 (2%, 4%, and 16%) vs matching vehicle, administered once daily for 14 days, in subjects with culture-confirmed interdigital tinea pedis. The primary efficacy outcome was the proportion of subjects with negative fungal cultures at end of treatment (day 14). Secondary outcomes at days 14 and 42 were the proportion of subjects with mycological cure (negative potassium hydroxide wet mount skin test and culture), clinical cure (reduced signs and symptoms from baseline graded on a 4-point scale). Safety was monitored through physical examinations, adverse events, and hemoglobin and methemoglobin levels. Efficacy outcomes were analyzed using a two-sided Cochran-Mantel-Haenszel test for general association, stratified by site.

RESULTS:
At day 14, a higher proportion of patients had negative fungal cultures in the pooled SB208-treated group (62%; P=0.04) than the vehicle-treated group (43%). Of SB208 groups, the 4% group had higher incidence of negative fungal cultures vs the vehicle group (67.6% vs 42.9%; P=0.03). At day 42, pooled SB208-treated groups had significantly more mycological cure vs vehicle group (47% vs 31%, respectively; P=0.08), and clinical cure was maintained in 23% of pooled SB208-treated patients vs 14% of vehicle-treated patients. No safety concerns were reported. Adverse events were mild, not serious, and considered unrelated to study medications.

CONCLUSIONS:
Topical SB208 was effective and well tolerated in the treatment of tinea pedis.
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