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an explanation of the antibacterial characteristics of maltodextrin nf anthony n silvetti md anthony n silvetti jr md infection is among the most important factors in delaying and preventing the healing of wounds and ulcers it has recently been stated that all of the topical antimicrobials employed to control wound/burn infection impeded wound healing maltodextrin is a natural product obtained by hydrolysis of starch chemically it is a d-glucose polysaccharide polymer with an average molecular weight ranging around 3000 daltons it contains small amounts of sugars glucose and maltose and large amounts of higher molecular weight polysaccharides clinical trials show that the topical application of maltodextrin controls odor causing bacteria and eliminates infection in wounds and ulcers promoting the growth of highly vascularized granulation tissue illustrating the antibacterial and wound healing characteristics of maltodextrin nf 2 3 4 5 experimental it was decided to test in-vitro the antibacterial properties of maltodextrin in view of the excellent clinical results control and experimental erlenmeyer flasks were filled with appropriate growth medium tsb and sterilized to the experimental flasks maltodextrin nf powder was added in 10 20 30 50 and 70 concentrations w/v all the flasks were inoculated with atcc registered strains of pseudomonas aeruginosa staphylococcus aureus escherichia coli and streptococcus fecalis bacterial growth over time was measured by the increase in the turbidity of the medium using a coleman-hitachi spectrophotometer bacterial growth inhibition was manifested by decrease in the turbidity of the medium results for all of the bacteria tested growth was inhibited in-vitro by maltodextrin nf a 20 solution of maltodextrin nf in tsb medium resulted in more than 50 inhibition whereas a 70 solution totally inhibited bacterial growth electron microscopy bacteria exposed to a 20 maltodextrin nf solution for 6 hours at 37 degree centigrade showed the following structural changes 1 plasmolysis 2 swelling and stripping of bacterial membrane and 3 formulation of membrane pores generated porins membrane proteins that are believed to be specifically activated by a maltose-maltodextrin complex of maltodextrin nf 6&7 any of the above changes may be conducive to bacterial death bacteriocidal effect conclusion maltodextrin nf is bacteriostatic to aerobic and anaerobic gram positive and gram negative bacteria in-vitro 1

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references 1 heggers j.p et al sbhan it s antibacterial and wound healing properties wound repair and regeneration volume 3 number 1 1995:92 2 silvetti a.n an effective method of treating long-enduring wounds and ulcers by topical application of nutrients j dermatol surg oncol 1981-7:501-508 3 silvetti a.n mechanisms involved in wound healing faseb journal 1993 3-a5956 a1251 4 silvetti a.n polysaccharides as effective chemo-attractants to white blood cells and macrophages federation proc 1987 46 a3868980 5 braun joseph silvetti anthony n xakellis george c what really works for pressure sores patient care 1992 jan 30 63-83 6 schwartz maxime the maltose regulon escherichia coli and salmonella typhimurium american society of microbiology 1987 1482-1502 7 monod j and torriani a.m 1948 comptes rendus academie sciences vol 277 240-246 2

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the chemotactic activity of maltodextrin n.f on polymorphonuclear leukocytes a comparative in-vitro study using the boyden chamber anthony n silvetti md it is well known that simple sugars such as glucose and other monosaccharides exert chemotactic activity towards leukocytes in particular polymorphonuclear leukocytes pmn it has been observed in hundreds of clinical cases of chronic and infected human wounds/ulcers that following the application of maltodextrin nf the infection and purulence began to decrease immediately and disappeared almost completely within 2 4 days it is believed that this control of local infection and purulence may be due in part to the action of the patient s own leukocytes that are attracted to the infected wound/ulcer site by the chemotactic properties of maltodextrin nf and proceed to phagocyte and kill bacteria present therein maltodextrin nf is a natural medium molecular weight d-glucose polysaccharide consisting of a mixture of mono di tri tetra hexa hepta and higher polysaccharides and is obtained by gentle acid and enzymatic digestion of plant starches in order to test this hypothesis several in-vitro and in-vivo experiments were carried out to determine if maltodextrin nf is indeed chemotactic to leukocytes polymorphonuclear leukocytes lymphocytes and monocytes and if its chemotactic action is stronger than other substances 3

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materials and methods maltodextrin nf a pure maltodextrin powder with a dextrose equivalence d.e of 10 12 and an average molecular weight of 3000 daltons was used it was sterilized by gamma radiation and preserved in tight aluminum foil packets guinea-pigs white guinea-pigs nmri stock weight 400 grams were used in order to harvest the necessary polymorphonuclear cells pmn several guinea-pigs were injected intraperitoneally with sterile mineral oil under strict aseptic conditions this produced in 48 72 hours a large harvest of intraperitoneal pmn leukocytes suspended in intraperitoneal fluid this fluid was carefully collected and stored for the experiments boyden chamber for chemotactic experiments this experimental chamber was divided into 2 compartments by a micropore filter whose pores are small enough to allow passage of simple molecules and macromolecules but not cells such as pmn cells and other leukocytes during the chemotaxis experiments the pmn cells from the guinea-pig are placed in one compartment and the chemical substance being tested in the other for variable times in an incubator at 37 degrees c materials and substances tested for chemotactic action 1 maltodextrin nf powder described above used in 10 and 30 solutions 2 chemokinesis control chemotaxis control a standard for chemokinesis or chemotaxis activity 3 n-f-met-leu-phe polypeptide a well known and effective chemo-attractant 4 rpmi 1640 roswell park memorial institute tissue culture medium containing basic nutrients including amino acids 5 sucrose table sugar in a 10 dilution used for centuries in the treatment of wounds and ulcers 4

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results the following are the results observed material tested rpmi 1640 10 sucrose chemokinesis control n-f-met-leu-phe polypeptide 10 maltodextrin nf 30 maltodextrin nf cells attracted 4 cells/field 5 cells/field 10 cells/field 60 cells/field 9 cells/field 185 cells/field conclusions it was shown that the 30 solution of maltodextrin nf attracted an average of 185 cells per field it is therefore established that this 30 solution is the most active chemotactic substance tested in these experiments in the in-vivo treatment of patients with deep full-thickness skin wounds/ulcers maltodextrin nf powder full strength has been used originally the concentration of the powder when first applied to the wound/ulcer is 100 as the powder draws some of the wound/ulcer fluid its concentration will decrease slightly to a 95 97 range in these clinical cases the chemotactic activity of the maltodextrin nf powder was much higher than that of the 30 dilution used for this experiment the outstanding infection control and cleansing effect on necrotic infected tissue of wounds/ulcers in the clinical setting may be explained by the active phagocytic effects of the chemotactically attracted polymorphonuclear cells and other leukocytes 5

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the role of maltodextrin nf in wound healing an explanation of the chemotactic activity of maltodextrin nf anthony n silvetti md maltodextrin nf powder is a mixture of monosaccharides glucose and several polysaccharides with increasing molecular weights this polysaccharide mixture is obtained by gentle and controlled acid and enzymatic digestion of plant starches the average molecular weight of the maltodextrin powder used in these studies is 3,000 daltons in experimental in-vitro studies using the boyden chamber it has been demonstrated that maltodextrin is highly chemotactic to polymorphonuclear cells pmns as a matter of fact maltodextrin in a 30 solution is the most active chemotactic solution tested in these studies the wound healing enhancing effect of maltodextrin could be explained by the large number of pmn cells that contain known specific growth factors as well as bacteriostatic and bacteriocidal factors resulting in overall increased phagocytic activity phagocytosis against tissue debris purulent exudate and bacteria in 1962 dr robert chambers a new york university biologist known for the development of the chambers micro cell manipulator demonstrated that starches glycogen and sugars such as sucrose maltose lactose fructose and glucose in 2 to 5 tryode solution exerted a positive chemotactic effect on polymorphonuclear leukocytes pmns specifically starch solutions incubated with animal serum containing serum amylases for several hours were highly chemotactic to pmn leukocytes this reaction was due to the partial breakdown of the starch molecules by amylases present in the serum these products of starch breakdown are similar to maltodextrin nf molecules also obtained by enzymatic breakdown of starch hence maltodextrin nf is highly chemotactic to pmn leukocytes and the presence of maltodextrin nf at the wound site should assist in the wound healing process 6

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in-vitro tests recently dr gary r grotendorst published an article titled chemoattractants and growth factors a chapter in wound healing by cohen diegelman and lindblad published by w.b saunders company 1992 in this article dr grotendorst states during chemotaxis cells respond to a chemical factor chemoattractant and move in the direction of an increasing concentration of that factor the best characterized chemotactic response of mammalian cells is the directed migration of phagocytic cells primarily macrophages and polymorphonuclear neutrophils to sites of infection or trauma phagocytic cells recognize factors secreted by the infecting organism as well as those generated in the traumatized areas and migrate toward their source however chemotaxis is not limited to phagocytic cells and has been observed in other cell types including fibroblasts smooth muscle cells and endothelial cells and our understanding of chemotaxis is based largely on in-vitro systems used to assess the migrating responses of cells the boyden chamber is the most commonly used therefore the boyden chamber assay was used to compare the chemotactic effects of maltodextrin nf in-vitro versus other compounds/solutions see attached report the chemotactic activity of maltodextrin nf on polymorphonuclear leukocytes 7

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