Comparison of the therapeutic efficacy of oral doses of fluconazole and itraconazole in a guinea pig model of dermatophytosis

Development, Optimization, and In Vitro/In Vivo Evaluation of Azelaic Acid Transethosomal Gel for Antidermatophyte Activity

Treatment of dermatophytosis is quite challenging. This work aims to investigate the antidermatophyte action of Azelaic acid (AzA) and evaluate its efficacy upon entrapment into transethosomes (TEs) and incorporation into a gel to enhance its application. Optimization of formulation variables of TEs was carried out after preparation using the thin film hydration technique. The antidermatophyte activity of AzA-TEs was first evaluated in vitro. In addition, two guinea pig infection models with Trichophyton (T.) mentagrophytes and Microsporum (M.) canis were established for the in vivo assessment. The optimized formula showed a mean particle size of 219.8 ± 4.7 nm and a zeta potential of -36.5 ± 0.73 mV, while the entrapment efficiency value was 81.9 ± 1.4%. Moreover, the ex vivo permeation study showed enhanced skin penetration for the AzA-TEs (3056 µg/cm²) compared to the free AzA (590 µg/cm²) after 48 h. AzA-TEs induced a greater inhibition in vitro on the tested dermatophyte species than free AzA (MIC₉₀ was 0.01% vs. 0.32% for T. rubrum and 0.032% for T. mentagrophytes and M. canis vs. 0.56%). The mycological cure rate was improved in all treated groups, specially for our optimized AzA-TEs formula in the T. mentagrophytes model, in which it reached 83% in this treated group, while it was 66.76% in the itraconazole and free AzA treated groups. Significant (p < 0.05) lower scores of erythema, scales, and alopecia were observed in the treated groups in comparison with the untreated control and plain groups. In essence, the TEs could be a promising carrier for AzA delivery into deeper skin layers with enhanced antidermatophyte activity.

Synthesis and fungistatic activity of aryl aldoxime derivatives

OBJECTIVE

The antifungal activity of 13 arylaldoxime ester and ether derivatives was tested against 4 dermatophytes Trichophyton mentagrophytes (TM), Microsporum canis (MC); M. cookei, and M. gypseum.

MATERIALS AND METHODS

Structures of all new compounds prepared from aryl aldehydes were established by spectral means. The tests were performed on the Sabouraud Dextrose Agar (SDA) substrate. The sensitivity of the dermatophyte strains towards oxime derivatives was established by determining MIC and MFC values.

RESULTS

The tested compounds showed a moderate fungicidal activity reaching 100% inhibition rate at 1% concentration. The activity against M. canis of 4 derivatives was higher than the activity of a reference drug clotrimazole.

CONCLUSION

A novel group of biologically active compounds was introduced. Simple aldoxime derivatives can be developed into a new class of antifungals.

Animal model of dermatophytosis

Dermatophytosis is superficial fungal infection caused by dermatophytes that invade the keratinized tissue of humans and animals. Lesions from dermatophytosis exhibit an inflammatory reaction induced to eliminate the invading fungi by using the host's normal immune function. Many scientists have attempted to establish an experimental animal model to elucidate the pathogenesis of human dermatophytosis and evaluate drug efficacy. However, current animal models have several issues. In the present paper, we surveyed reports about the methodology of the dermatophytosis animal model for tinea corporis, tinea pedis, and tinea unguium and discussed future prospects.

Physically cross-linked polyvinyl alcohol for the topical delivery of fluconazole

The aim of this study was to develop fluconazole in an ultrapure polyvinyl alcohol (PVA) hydrogel able to deliver the drug in a sustained release pattern for local treatment of skin fungal infections. The topical fluconazole hydrogels were prepared using PVA hydrogels physically cross-linked by freeze-thaw technique. Polyethylene glycol (PEG) was added as a hydrophilic excipient as a release enhancer of fluconazole. The effects of PVA molecular weight, PEG molecular weight, and PEG concentration were studied using a 2 x 4 x 2 factorially designed experiment. The selected fluconazole hydrogel proved to be physically stable over a period of 6 months and to be effective in the topical treatment of cutaneous candidiasis. Therefore, it could be concluded that the formula composed of 10% PVA 205000 and 1.5% PEG 4000 and 2% fluconazole and prepared by three cycles of freezing, and thawing is very promising in the local treatment of skin fungal infection as an alternative to the systemic use of fluconazole.

Transcriptional profiles of Trichophyton rubrum in response to itraconazole

Trichophyton rubrum is the predominant causative agent for superficial dermatomycosis. In order to understand how triazole antifungal agents interact with dermatophytes, the gene expression response of T. rubrum to itraconazole was studied by large-scale gene expression profiling. A total of 670 genes were found to be responsive to itraconazole, including 305 that were up-regulated and 365 down-regulated. Most genes involved in lipid metabolism and especially in ergosterol biosynthesis were up-regulated in response to itraconazole, including ERG6, ERG7, ERG11, ERG24, ERG25 and ERG26. In addition, transcription of some genes involved in cell stress response, drug efflux, and small molecule transport was also affected by itraconazole. Differential expression of selected genes was confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR). This is the first microarray hybridization analysis of T. rubrum exposed to a triazole antifungal agent.

Intracutaneous distributions of fluconazole, itraconazole, and griseofulvin in Guinea pigs and binding to human stratum corneum

We have compared the distribution of fluconazole (FLC) with that of itraconazole (ITC) and griseofulvin (GRF) in the abdominal skin tissues after a single oral dose was administered to guinea pigs. The FLC concentrations in the stratum corneum reached a peak at 2 h after administration and were similar to those of ITC and higher than those of GRF in spite of the administration of a lower dose. GRF was eliminated from the stratum corneum faster than FLC and ITC. The FLC concentrations were also remarkably higher than those of ITC and GRF in the epidermis-cutis but lower in the subcutaneous fatty tissue. The distribution characteristics of each drug result from differences in their physicochemical properties. Following the administration of multiple doses, the FLC concentrations in the stratum corneum were highest in the abdominal skin tissues; those at 24 h after each administration increased gradually and were maintained at a level more than 10 times higher than that of the plasma concentrations. The FLC concentrations in the planta pedis stratum corneum and in the nail showed good dose proportionality and obvious accumulation and were 60 and 40 times as high as that in plasma on day 14. The extent of binding of FLC to human corneous keratin in vitro was about 10%, which is lower than those of ITC (94 to 97%) and GRF (36 to 38%). FLC, unlike ITC, therefore, is presumed to exist in the stratum corneum at high concentrations in an active nonbinding form. These excellent intracutaneous pharmacokinetic properties of FLC probably account in large part for the in vivo efficacy of FLC.

Fungal diseases of laboratory rodents

Although fungal disease is uncommon in rodents, dermatophytosis is the most common mycosis seen in clinical practice. T. mentagrophytes is the most common etiologic agent, and the guinea pig is the most common species affected, although there are reports in all pet and laboratory rodent species except the gerbil. Despite the low incidence of clinical disease, rodents are common asymptomatic carriers of dermatophytes, and ringworm is the most common zoonotic disease transmitted from rodents to people.