Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2 Infectivity In Vitro
Xu et al.,
Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2 Infectivity In Vitro,
Pathogens, doi:10.3390/pathogens10030272 (In Vitro)
Xu et al., 1 Mar 2021, peer-reviewed, 7 authors.
In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
Abstract: pathogens
Article
Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2
Infectivity In Vitro
Chuan Xu 1 , Annie Wang 1 , Eileen R. Hoskin 2 , Carla Cugini 3 , Kenneth Markowitz 3 , Theresa L. Chang 1,4, * and
Daniel H. Fine 3, *
1
2
3
4
*
Citation: Xu, C.; Wang, A.; Hoskin,
E.R.; Cugini, C.; Markowitz, K.;
Chang, T.L.; Fine, D.H. Differential
Effects of Antiseptic Mouth Rinses on
SARS-CoV-2 Infectivity In Vitro.
Pathogens 2021, 10, 272. https://
doi.org/10.3390/pathogens10030272
Academic Editor: Sonia Zuñiga
Received: 1 February 2021
Accepted: 22 February 2021
Published: 1 March 2021
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Public Health Research Institute, Rutgers, New Jersey Medical School, 225 Warren Street,
Newark, NJ 07103, USA; cx89@njms.rutgers.edu (C.X.); aw768@njms.rutgers.edu (A.W.)
Department of Restorative Dentistry, School of Dental Medicine, Rutgers, The State University of New Jersey,
Newark, NJ 07103, USA; hoskiner@sdm.rutgers.edu
Department of Oral Biology, School of Dental Medicine, Rutgers, The State University of New Jersey,
Newark, NJ 07103, USA; cc1337@sdm.rutgers.edu (C.C.); markowkj@sdm.rutgers.edu (K.M.)
Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers,
The State University of New Jersey, Newark, NJ 07103, USA
Correspondence: theresa.chang@rutgers.edu (T.L.C.); finedh@sdm.rutgers.edu (D.H.F.);
Tel.: +1-973-854-3265 (T.L.C.); +1-973-972-3728 (D.H.F.); Fax: +1-973-854-3101 (T.L.C.);
+1-973-972-0045 (D.H.F.)
Abstract: Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) is detectable in saliva
from asymptomatic individuals, suggesting a potential benefit from the use of mouth rinses to suppress viral load and reduce virus spread. Published studies on the reduction of SARS-CoV-2-induced
cytotoxic effects by mouth rinses do not exclude antiseptic mouth rinse-associated cytotoxicity. Here,
we determined the effect of commercially available mouth rinses and antiseptic povidone-iodine
on the infectivity of replication-competent SARS-CoV-2 viruses and of pseudotyped SARS-CoV-2
viruses. We first determined the effect of mouth rinses on cell viability to ensure that antiviral activity
was not a consequence of mouth rinse-induced cytotoxicity. Colgate Peroxyl (hydrogen peroxide)
exhibited the most cytotoxicity, followed by povidone-iodine, chlorhexidine gluconate (CHG), and
Listerine (essential oils and alcohol). The potent antiviral activities of Colgate Peroxyl mouth rinse
and povidone-iodine were the consequence of rinse-mediated cellular damage when the products
were present during infection. The potency of CHG was greater when the product was not washed
off after virus attachment, suggesting that the prolonged effect of mouth rinses on cells impacts
the antiviral outcome. To minimalize mouth rinse-associated cytotoxicity, mouth rinse was largely
removed from treated viruses by centrifugation prior to infection of cells. A 5% (v/v) dilution of
Colgate Peroxyl or povidone-iodine completely blocked viral infectivity. A similar 5% (v/v) dilution
of Listerine or CHG had a moderate suppressive effect on the virus, but a 50% (v/v) dilution of
Listerine or CHG blocked viral infectivity completely. Mouth rinses inactivated the virus without
prolonged incubation. The new infectivity assay, with limited impacts of mouth rinse-associated
cytotoxicity,..
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