Hydrogen
sulfide, the volcanic gas that smells of rotten eggs, could be used in a new
treatment for tricky nail infections that acts faster and with fewer side
effects, according to scientists at the University of Bath and King's College
London (KCL).
The research is published in Scientific Reports.
Nail infections are mostly caused by fungi and
occasionally by bacteria. They are very common, affecting between 4 and 10% of
the global population, rising to nearly half those aged 70 or over. These
infections can lead to complications, particularly in vulnerable groups such as diabetics and the elderly, but are notoriously difficult
to treat.
Current treatments include oral antifungals taken in
pill form, and topical treatments applied directly to the nail. Oral antifungals take around 2–4 months to act and are reasonably
effective, but they carry risks of side effects, especially in patients with
other medical conditions.
Treatments applied directly to the nail are safer, but
they often take much longer to work, sometimes taking even years to work, and
they frequently relapse or fail. This is largely because it's very difficult to
get the drug to penetrate through the nail to where the infection resides.
Even the most effective topical treatments have
relatively low cure rates, so there is a clear need for new therapeutic
approaches that are safe, effective, and capable of reaching microbes embedded
deep within the nail.
A team from the University of Bath and King's College
London has now found that hydrogen sulfide (H₂S), a small, naturally occurring
gas, could be developed into a promising new treatment.
Previous work has shown that it penetrates the nail
plate far more efficiently than existing topical drugs, and now the team has
demonstrated that it has strong antimicrobial activity against a wide range of
nail pathogens, including fungi that are resistant to common antifungal
treatments.
In laboratory tests, the team used a chemical that breaks down to release the hydrogen sulfide gas and found that it acts in a unique way, disrupting microbial
energy production and triggering irreversible damage, ultimately killing the
fungi.
Dr. Albert Bolhuis, from the University of Bath's
Department of Life Sciences, said, "Thanks to its ability to efficiently
reach the site of infection and its novel mode of action, we believe that a
topically applied medicine containing hydrogen sulfide could become a highly effective new treatment for nail infections,
which avoids the limitations of current therapies.
"Our research lays the foundation for a
compelling alternative to existing treatments, with the potential to improve
outcomes for patients suffering from persistent and drug-resistant fungal nail
infections."
Hydrogen sulfide is known for its pungent smell of
rotten eggs, and has some toxicity. However, researchers believe the amounts
required are well below toxicity levels and the correct formulation will limit
any unpleasant odors.
The research has so far only been done in vitro, but
the team hopes to develop a treatment that could be used in patients in the
next five years.
Professor Stuart Jones, Director of the Center for
Pharmaceutical Medicine Research at KCL said, "We are looking forward to
translating these findings into an innovative topical product that can treat
nail infection."
Source: 'Rotten egg' gas could be the answer to treating nail infections, say scientists

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