Significance of chlorine-dioxide-based oral rinses in preventing SARS-CoV-2 cell entry

Oral Dis. 2022 Nov:28 Suppl 2:2481-2491. doi: 10.1111/odi.14319. Epub 2022 Jul 28.

Abstract

Objective: This work aims to determine the efficacy of preprocedural oral rinsing with chlorine dioxide solutions to minimize the risk of coronavirus disease 2019 (COVID-19) transmission during high-risk dental procedures.

Methods: The antiviral activity of chlorine-dioxide-based oral rinse (OR) solutions was tested by pre-incubating with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pseudovirus in a dosage-dependent manner before transducing to human embryonic kidney epithelial (HEK293T-ACE2) cells, which stably expresses ACE-2 receptor. Viral entry was determined by measuring luciferase activity using a luminescence microplate reader. In the cell-to-cell fusion assay, effector Chinese hamster ovary (CHO-K1) cells co-expressing spike glycoprotein of SARS-CoV-2 and T7 RNA polymerase were pre-incubated with the ORs before co-culturing with the target CHO-K1 cells co-expressing human ACE2 receptor and luciferase gene. The luciferase signal was quantified 24 h after mixing the cells. Surface expression of SARS-CoV-2 spike glycoprotein and ACE-2 receptor was confirmed using direct fluorescent imaging and quantitative cell-ELISA. Finally, dosage-dependent cytotoxic effects of ORs were evaluated at two different time points.

Results: A dosage-dependent antiviral effect of the ORs was observed against SARS-CoV-2 cell entry and spike glycoprotein mediated cell-to-cell fusion. This demonstrates that ORs can be useful as a preprocedural step to reduce viral infectivity.

Conclusions: Chlorine-dioxide-based ORs have a potential benefit for reducing SARS-CoV-2 entry and spread.

Keywords: SARS-CoV-2; chlorine dioxide; preprocedural oral rinses; viral entry; virus-host cell interactions.

MeSH terms

  • Angiotensin-Converting Enzyme 2
  • Animals
  • Antiviral Agents / pharmacology
  • CHO Cells
  • COVID-19* / prevention & control
  • Chlorine / pharmacology
  • Cricetinae
  • Cricetulus
  • HEK293 Cells
  • Humans
  • Mouthwashes / pharmacology
  • SARS-CoV-2*
  • Virus Internalization

Substances

  • Angiotensin-Converting Enzyme 2
  • Antiviral Agents
  • Chlorine
  • chlorine dioxide
  • Mouthwashes