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Oladzad V, Nasrollahi Omran A, Haghani I, Nabili M, Guillot J, Seyedmousavi S, Hedayati MT. Asymptomatic colonization of stray dogs and domestic cats with Trichophyton mentagrophytes II in Northern Iran. J Mycol Med 2024; 34:101496. [PMID: 38986423 DOI: 10.1016/j.mycmed.2024.101496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/19/2024] [Accepted: 06/24/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Despite changes in the epidemiology of dermatophyte infections, the incidence of fungal infections associated with Trichophyton species still remains high among dogs and cats. The objective of the present study was to isolate and characterize dermatophytes from dogs and cats in Iran. METHOD From December 2022 to May 2023, skin and hair samples were collected from symptomatic and asymptomatic cats and dogs in Mazandaran, a northern province of Iran. The samples were then inoculated into Mycosel™ Agar. Dermatophyte isolates were identified by sequencing the internal transcribed spacer region. Antifungal susceptibility tests were conducted using the Clinical and Laboratory Standards Institute (CLSI-M38-A3). RESULT Of the 250 samples collected (from 200 dogs and 50 cats), 20 (from 19 dogs and one cat) (8.0 %) were positive for dermatophyte growth. Based on sequence and phylogenetic analysis, all isolates belonged to T. mentagrophytes II*. Of these positive samples, 14 (70.0 %), 3 (15.0 %), 2 (10.0 %), and 1 (2.0 %) were isolated from asymptomatic stray dogs, symptomatic stray dogs, symptomatic domestic dogs, and symptomatic cats, respectively. Luliconazole and terbinafine displayed potent activity against all T. mentagrophytes isolates, with Minimum inhibitory concentration (MIC) values of 0.016 µg/ml. Miconazole and griseofulvin demonstrated higher MIC (1 and 8 µg/ml). CONCLUSION The present study indicated that T. mentagrophytes II* asymptomatic carriage is frequent in stray dogs in Iran. The potential risk to public health needs to be evaluated However, T. mentagrophytes genotype VIII, considered as an endemic and emerging human pathogenic clone in several countries, was not detected during the present survey.
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Affiliation(s)
- Vahid Oladzad
- Department of Mycology, Faculty of Medical Sciences, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran
| | - Ayatollah Nasrollahi Omran
- Department of Mycology, Faculty of Medical Sciences, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran; Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mojtaba Nabili
- Department of Medical Laboratory Sciences, Faculty of Medical Sciences, Sari Branch, Islamic Azad University, Sari, Iran
| | - Jacques Guillot
- Oniris, Clinical Sciences Department, Nantes, France; Université d'Angers, Université de Brest, IRF, SFR ICAT, Angers, France
| | - Seyedmojtaba Seyedmousavi
- Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Mohammad Taghi Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran; Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
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He X, Lu Y. Successful combined treatment with surgery and ALA-PDT for cutaneous infection by candida tropicalis: A case report and literature review. Photodiagnosis Photodyn Ther 2024; 49:104303. [PMID: 39117160 DOI: 10.1016/j.pdpdt.2024.104303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 07/29/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024]
Abstract
Candidiasis is a common fungal infection, with Candida tropicalis infections being relatively rare. These infections develop into skin fungal infections under conditions such as broad-spectrum antibiotic use, diabetes, and immunosuppression. Traditionally, antifungal drugs have been the primary treatment; however, issues like hepatotoxicity and the need for long-term use persist. Consequently, new treatment approaches are essential. Most previous reports have focused on Candida albicans, with fewer addressing Candida tropicalis. This study reports a case where a patient with a skin Candida tropicalis infection was treated with a combination of surgery and ALA photodynamic therapy(635 nm, 120 J/cm2, 177 mW/cm2). After just one session of this combined treatment, the patient achieved significant clinical remission. Therefore, the combination of surgery and ALA-PDT may offer a safe and effective treatment option.
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Affiliation(s)
- Xian He
- Department of Plastic & Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing 400042, PR China
| | - Yuangang Lu
- Department of Plastic & Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing 400042, PR China.
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Uysal C, Oguz H, Cifci H, Kocyigit I. Widespread form of Majocchi's granuloma in a kidney transplant recipient. CEN Case Rep 2024:10.1007/s13730-024-00883-1. [PMID: 38763967 DOI: 10.1007/s13730-024-00883-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/23/2024] [Indexed: 05/21/2024] Open
Abstract
Kidney transplantation is the encouraged kidney replacement therapy due to providing more prolonged survival with a better quality of life. Unfortunately, kidney transplant recipients are susceptible to infections because of long-term utilization of immunosuppression. Despite dermatophyte infections are generally not life-threatening, the clinical significance has been recently enhanced by an increasing number of immunocompromised patients. We have presented a rare dermatophytosis course, Majocchi's granuloma, that spreads to all extremities during the early post-transplant period. A young kidney transplant recipient was exposed to intensive immunosuppression therapy due to acute rejection in the early period of post-transplantation. After four months, numerous nodular skin lesions were raised on various body parts. An invasive fungal infection was identified in the skin biopsy. Also, Trichophyton rubrum was isolated in the tissue cultures. Consequently, the patient was diagnosed with Majocchi's granuloma. An effectual treatment was attained with an oral terbinafine tablet. Majocchi's granuloma is a distinct form of dermatophytosis characterized by the spreading of infection into the dermis. In this unexpected case, we alerted physicians to opportunistic infections in the kidney transplant recipient.
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Affiliation(s)
- Cihan Uysal
- Department of Nephrology, Erciyes University Medical Faculty, Köşk Distinct, Dede Efendi Street, 38039, Melikgazi, Kayseri, Turkey.
| | - Hanife Oguz
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Hasan Cifci
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ismail Kocyigit
- Department of Nephrology, Erciyes University Medical Faculty, Köşk Distinct, Dede Efendi Street, 38039, Melikgazi, Kayseri, Turkey
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Abdel Azim S, Whiting C, Friedman AJ. Applications of nitric oxide-releasing nanomaterials in dermatology: Skin infections and wound healing. Nitric Oxide 2024; 146:10-18. [PMID: 38458595 DOI: 10.1016/j.niox.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/19/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
Nitric oxide (NO) is produced in most cells in the skin and is an important regulator of essential cutaneous functions, including responses to UV irradiation, microbial defense, wound healing, melanogenesis and epidermal permeability barrier homeostasis. Harnessing the physiological activities of NO for therapeutic use is difficult because the molecule is highly reactive and unstable. A variety of exogenous NO delivery platforms have been developed and evaluated; however, they have limited clinical applications in dermatology due to instability and poor cutaneous penetration. NO-releasing nanomaterials overcome these limitations, providing targeted tissue delivery, and sustained and controlled NO release. This review provides a comprehensive and up-to-date evaluation of the use of NO-releasing nanomaterials in dermatology for the treatment of skin and soft tissue infections and wound healing.
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Affiliation(s)
- Sara Abdel Azim
- Georgetown University School of Medicine, Washington, DC, USA
| | - Cleo Whiting
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Adam J Friedman
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
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Abstract
The population of older adults continues to increase in the United States, leading to a concomitant increase in cutaneous disease. Fungal disease, specifically, commonly affects this population but often goes undiagnosed for too long. It is therefore important that providers be aware of common fungal pathogens, recognizable symptoms of disease, and treatment options. This article discusses 3 groups of pathogens: dermatophytes, Candida species, and Pityrosporum species, all of which cause a host of conditions that can be debilitating for older adults.
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Affiliation(s)
- Saniya Shaikh
- Department of Dermatology, SSM Health SLU Care Physician Group Saint Louis University School of Medicine, 1225 S Grand Boulevard, Saint Louis, MO 63104, USA.
| | - Aditya Nellore
- Department of Internal Medicine, St. Luke's Hospital, 232 S Woods Mill Road, Chesterfield, MO 63017, USA
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Tarannum N, Pooja K, Jakhar S, Mavi A. Nanoparticles assisted intra and transdermic delivery of antifungal ointment: an updated review. DISCOVER NANO 2024; 19:11. [PMID: 38195832 PMCID: PMC10776542 DOI: 10.1186/s11671-023-03932-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
This review paper highlights the trans-dermic delivery of nanoparticles (NPs) based antifungal ointments with the help of nanotechnology. It also describes the novel trans-dermal approach utilizing various nanoparticles which enables an efficient delivery to the target site. This current review gives an overview about past research and developments as well as the current nanoparticle-based ointments. This review also presents data regarding types, causes of infection, and different pathogens within their infection site. It also gives information about antifungal ointments with their activity and side effects of antifungal medicines. Additionally, this review also focuses on the future aspects of the topical administration of nanoparticle-based antifungal ointments. These nanoparticles can encapsulate multiple antifungal drugs as a combination therapy targeting different aspects of fungal infection. Nanoparticles can be designed in such a way that they can specifically target fungal cells and do not affect healthy cells. Nanoparticle based antifungal ointments exhibit outstanding potential to treat fungal diseases. As further research and advancements evolve in nanotechnology, we expect more development of nanoparticle-based antifungal formulations shortly. This paper discusses all the past and future applications, recent trends, and developments in the various field and also shows its bright prospective in the upcoming years.
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Affiliation(s)
- Nazia Tarannum
- Department of Chemistry, Chaudhary Charan Singh University, Meerut, 250004, Uttar Pradesh, India.
| | - Km Pooja
- Department of Chemistry, Chaudhary Charan Singh University, Meerut, 250004, Uttar Pradesh, India
| | - Shivani Jakhar
- Department of Chemistry, Chaudhary Charan Singh University, Meerut, 250004, Uttar Pradesh, India
| | - Anshika Mavi
- Department of Chemistry, Chaudhary Charan Singh University, Meerut, 250004, Uttar Pradesh, India
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Rana DK, Shah TS, Rohit MH, Patel NH, Khadela AD, Oza YP, Padhiyar JK. Evaluation of the benefit of the addition of 1% topical luliconazole versus topical bland emollient to the systemic itraconazole therapy for the management of disseminated dermatophytosis: A randomised control trial. Mycoses 2024; 67:e13681. [PMID: 38214352 DOI: 10.1111/myc.13681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The present epidemic of dermatophytosis in India is marked by an increase in chronic, recurrent and disseminated cases. A combination of oral itraconazole and topical luliconazole is being increasingly utilised by dermatologists in India. The superiority of this combination is not supported by robust clinical trial data. OBJECTIVE We conducted this randomised, open-label, two arms, parallel assignment intervention trial between November 2022 and May 2023 to determine the superiority of topical 1% Luliconazole over bland emollient as adjuvant to systemic Itraconazole therapy in the management of dermatophytosis. METHOD In this study, 135 patients of either sex were randomised to two study cohorts. Major exclusions being concomitant medical illness, use of concomitant medication and substance abuse. Participants were randomly assigned to receive topical bland emollient, (Cohort I, n = 67) or topical luliconazole, (Cohort II, n = 68). Both cohorts received oral itraconazole 200 mg/day (100 mg BID) and levocetirizine 5 mg twice a day as a systemic regime. Clinical and mycological cure at the end of 6 weeks and clinical relapse among cure patients during 10-week follow-up were observed. RESULTS The cure rates for Cohorts I and II at 6 weeks were 50 (74.62%) and 56 (82.35%), (p = .46), respectively. During the 4-week follow-up period, clinical relapses were observed in 16 (32%) of the 50 patients in Cohort I and 12 (21.43%) of the 56 patients in Cohort II (p = .18). Luliconazole cohort shows a significantly higher medical cost (p < .05). CONCLUSION Our study shows a similar cure rate and relapse rate for patients receiving topical Luliconazole versus topical bland emollient as an adjuvant to the systemic itraconazole regime.
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Affiliation(s)
- Deval K Rana
- Department of Pharmacology, L.M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Tithi S Shah
- Department of Pharmacology, L.M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Mansi H Rohit
- Department of Pharmacology, L.M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Nayankumar H Patel
- GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
| | - Avinash D Khadela
- Department of Pharmacology, L.M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Yaksh P Oza
- GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
| | - Jigna K Padhiyar
- GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
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Kruithoff C, Gamal A, McCormick TS, Ghannoum MA. Dermatophyte Infections Worldwide: Increase in Incidence and Associated Antifungal Resistance. Life (Basel) 2023; 14:1. [PMID: 38276250 PMCID: PMC10817648 DOI: 10.3390/life14010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
The increase in incidence of superficial fungal infections combined with the emergence of antifungal resistance represents both a global health challenge and a considerable economic burden. Recently, dermatophytes, the main culprit causing superficial fungal infections, have started to exhibit antifungal resistance. This can be observed in some of the most common species such as Trichophyton rubrum and Trichophyton mentagrophytes. Importantly, the new subspecies, known as Trichophyton indotineae, has been reported to show high resistance to terbinafine, a first-line treatment for dermatophyte infections. Compounding these issues is the realization that diagnosing the causative infectious agents requires using molecular analysis that goes beyond the conventional macroscopic and microscopic methods. These findings emphasize the importance of conducting antifungal susceptibility testing to select the appropriate antifungal necessary for successful treatment. Implementing these changes may improve clinical practices that combat resistant dermatophyte infections.
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Affiliation(s)
- Caroline Kruithoff
- Heritage College of Osteopathic Medicine, Ohio University, Cleveland, OH 44122, USA;
| | - Ahmed Gamal
- Center for Medical Mycology and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA; (A.G.); (T.S.M.)
| | - Thomas S. McCormick
- Center for Medical Mycology and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA; (A.G.); (T.S.M.)
| | - Mahmoud A. Ghannoum
- Center for Medical Mycology and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA; (A.G.); (T.S.M.)
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
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9
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Montgomery VA, Cain E, Styczynski MP, Prausnitz MR. Bacillus subtilis engineered for topical delivery of an antifungal agent. PLoS One 2023; 18:e0293664. [PMID: 38032939 PMCID: PMC10688720 DOI: 10.1371/journal.pone.0293664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/14/2023] [Indexed: 12/02/2023] Open
Abstract
Fungal skin infections are a common condition affecting 20-25 percent of the world population. While these conditions are treatable with regular application of an antifungal medication, we sought to develop a more convenient, longer-lasting topical antifungal platform that could increase patient adherence to treatment regimens by using Bacillus subtilis, a naturally antifungal bacteria found on the skin, for drug production and delivery. In this study, we engineered B. subtilis for increased production of the antifungal lipopeptide iturin A by overexpression of the pleiotropic regulator DegQ. The engineered strain had an over 200% increase in iturin A production as detected by HPLC, accompanied by slower growth but the same terminal cell density as determined by absorbance measurements of liquid culture. In an in vitro antifungal assay, we found that despite its higher iturin A production, the engineered strain was less effective at reducing the growth of a plug of the pathogenic fungus Trichophyton mentagrophytes on an agar plate compared to the parent strain. The reduced efficacy of the engineered strain may be explained by its reduced growth rate, which highlights the need to address trade-offs between titers (e.g. measured drug production) and other figures of merit (e.g. growth rate) during metabolic engineering.
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Affiliation(s)
- Veronica A. Montgomery
- Wallace H. Coulter Department of Biomedical Engineering at Emory University and Georgia Tech, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Ethan Cain
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Mark P. Styczynski
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Mark R. Prausnitz
- Wallace H. Coulter Department of Biomedical Engineering at Emory University and Georgia Tech, Georgia Institute of Technology, Atlanta, GA, United States of America
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
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10
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Fernandes C, Sousa-Baptista J, Lenha-Silva AF, Calheiros D, Correia E, Figueirinha A, Salgueiro L, Gonçalves T. Azorean Black Tea ( Camellia sinensis) Antidermatophytic and Fungicidal Properties. Molecules 2023; 28:7775. [PMID: 38067505 PMCID: PMC10707949 DOI: 10.3390/molecules28237775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The treatment of dermatophytoses, the most common human fungal infections, requires new alternatives. The aim of this study was to determine the antidermatophytic activity of the aqueous Azorean Black Tea extract (ABT), together with an approach to the mechanisms of action. The phytochemical analysis of ABT extract was performed by HPLC. The dermatophytes susceptibility was assessed using a broth microdilution assay; potential synergies with terbinafine and griseofulvin were evaluated by the checkerboard assay. The mechanism of action was appraised by the quantification of the fungal cell wall chitin and β-1,3-glucan, and by membrane ergosterol. The presence of ultrastructural modifications was studied by Transmission Electron Microscopy (TEM). The ABT extract contained organic and phenolic acids, flavonoids, theaflavins and alkaloids. It showed an antidermatophytic effect, with MIC values of 250 µg/mL for Trichophyton mentagrophytes, 125 µg/mL for Trichophyton rubrum and 500 µg/mL for Microsporum canis; at these concentrations, the extract was fungicidal. An additive effect of ABT in association to terbinafine on these three dermatophytes was observed. The ABT extract caused a significant reduction in β-1,3-glucan content, indicating the synthesis of this cell wall component as a possible target. The present study identifies the antidermatophytic activity of the ABT and highlights its potential to improve the effectiveness of conventional topical treatment currently used for the management of skin or mucosal fungal infections.
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Affiliation(s)
- Chantal Fernandes
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - José Sousa-Baptista
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- FMUC—Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Ana Filipa Lenha-Silva
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Daniela Calheiros
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- FMUC—Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Edmilson Correia
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Artur Figueirinha
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (A.F.); (L.S.)
- Associated Laboratory for Green Chemistry (LAQV) of the Network of Chemistry and Technology (REQUIMTE), University of Porto, 4099-002 Porto, Portugal
| | - Lígia Salgueiro
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (A.F.); (L.S.)
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3030-790 Coimbra, Portugal
| | - Teresa Gonçalves
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- FMUC—Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
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Dos Santos FL, Zilles JC, Machado AU, Marques MS, da Costa BS, Kulkamp Guerreiro IC, Fuentefria AM, Contri RV. Polymeric Nanocapsules Containing Ozonated Oil and Terbinafine Hydrochloride as a Potential Treatment Against Dermatophytes. AAPS PharmSciTech 2023; 24:198. [PMID: 37783861 DOI: 10.1208/s12249-023-02657-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/14/2023] [Indexed: 10/04/2023] Open
Abstract
Terbinafine hydrochloride is a synthetic allylamine whose mechanism of action consists of inhibiting the enzyme squalene epoxidase that participates in the first stage of ergosterol synthesis, interfering with fungal membrane function. Ozonated oils are used for topical application of ozone, producing reactive oxygen species that cause cellular damage in microorganisms, therefore being an alternative treatment for acute and chronic skin infections. This study aimed to develop and characterize Eudragit® RS100 nanocapsules, obtained by interfacial deposition of preformed polymer method, containing 0.5% terbinafine hydrochloride and 5% ozonated sunflower seed oil as a potential treatment against dermatophytes. The polymeric nanocapsules were characterized regarding particle size, zeta potential, pH, drug content, encapsulation efficiency, and stability. The in vitro drug release, in vitro skin permeation, and in vitro antifungal activity were also evaluated. The particle size was around 150 nm with a narrow size distribution, the zeta potential was around + 6 mV, and the pH was 2.2. The drug content was close to 95% with an encapsulation efficiency of 53%. The nanocapsules were capable to control the drug release and the skin permeation. The in vitro susceptibility test showed greater antifungal activity for the developed nanocapsules, against all dermatophyte strains tested, compared to the drug solution. Therefore, the polymeric nanocapsules suspension containing terbinafine hydrochloride and ozonated oil can be considered a potential high-efficacy candidate for the treatment of dermatophytosis, with a possible reduction in the drug dose and frequency of applications. Studies to evaluate safety and efficacy in vivo still need to be performed.
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Affiliation(s)
- Francielli Lima Dos Santos
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga, 2752, Azenha, Porto Alegre, RS, 90610-000, Brazil
| | - Júlia Capp Zilles
- Programa de Pós-Graduação em Ciências Farmacêuticas - PPGCF, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90610-000, Brazil
| | - Andressa Urbano Machado
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga, 2752, Azenha, Porto Alegre, RS, 90610-000, Brazil
| | - Morgana Souza Marques
- Programa de Pós-Graduação em Ciências Farmacêuticas - PPGCF, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90610-000, Brazil
| | - Bárbara Souza da Costa
- Programa de Pós-Graduação em Ciências Farmacêuticas - PPGCF, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90610-000, Brazil
| | - Irene Clemes Kulkamp Guerreiro
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga, 2752, Azenha, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas - PPGCF, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Farmacologia e Terapêutica - PPGFT, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | - Alexandre Meneghello Fuentefria
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga, 2752, Azenha, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas - PPGCF, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90610-000, Brazil
- Programa de Pós-Graduação em Farmacologia e Terapêutica - PPGFT, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90050-170, Brazil
| | - Renata Vidor Contri
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Av. Ipiranga, 2752, Azenha, Porto Alegre, RS, 90610-000, Brazil.
- Programa de Pós-Graduação em Ciências Farmacêuticas - PPGCF, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90610-000, Brazil.
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12
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Keshwania P, Kaur N, Chauhan J, Sharma G, Afzal O, Alfawaz Altamimi AS, Almalki WH. Superficial Dermatophytosis across the World's Populations: Potential Benefits from Nanocarrier-Based Therapies and Rising Challenges. ACS OMEGA 2023; 8:31575-31599. [PMID: 37692246 PMCID: PMC10483660 DOI: 10.1021/acsomega.3c01988] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023]
Abstract
The most prevalent infection in the world is dermatophytosis, which is a major issue with high recurrence and can affect the entire body including the skin, hair, and nails. The major goal of this Review is to acquire knowledge about cutting-edge approaches for treating dermatophytosis efficiently by adding antifungals to formulations based on nanocarriers in order to overcome the shortcomings of standard treatment methods. Updates on nanosystems and research developments on animal and clinical investigations are also presented. Along with the currently licensed formulations, the investigation also emphasizes novel therapies and existing therapeutic alternatives that can be used to control dermatophytosis. The Review also summarizes recent developments on the prevalence, management approaches, and disadvantages of standard dosage types. There are a number of therapeutic strategies for the treatment of dermatophytosis that have good clinical cure rates but also drawbacks such as antifungal drug resistance and unfavorable side effects. To improve therapeutic activity and get around the drawbacks of the traditional therapy approaches for dermatophytosis, efforts have been described in recent years to combine several antifungal drugs into new carriers. These formulations have been successful in providing improved antifungal activity, longer drug retention, improved effectiveness, higher skin penetration, and sustained drug release.
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Affiliation(s)
- Puja Keshwania
- Department
of Microbiology, Maharishi Markandeshwar
Institute of Medical Sciences and Research, Mullana, Ambala, Haryana 133207, India
| | - Narinder Kaur
- Department
of Microbiology, Maharishi Markandeshwar
Institute of Medical Sciences and Research, Mullana, Ambala, Haryana 133207, India
| | - Jyoti Chauhan
- Department
of Microbiology, Maharishi Markandeshwar
Institute of Medical Sciences and Research, Mullana, Ambala, Haryana 133207, India
| | - Gajanand Sharma
- University
Institute of Pharmaceutical Sciences, UGC-Centre of Advanced Studies, Panjab University, Chandigarh 160014, India
| | - Obaid Afzal
- Department
of Pharmaceutical Chemistry, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | | | - Waleed H. Almalki
- Department
of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah 21961, Saudi Arabia
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13
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Alves-Silva J, Zuzarte M, Cavaleiro C, Salgueiro L. Antibiofilm Effect of Lavandula multifida Essential Oil: A New Approach for Chronic Infections. Pharmaceutics 2023; 15:2142. [PMID: 37631356 PMCID: PMC10458520 DOI: 10.3390/pharmaceutics15082142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/21/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Fungal infections are associated with high morbidity and mortality rates, being highly prevalent in patients with underlying health complications such as chronic lung disease, HIV, cancer, and diabetes mellitus. To mitigate these infections, the development of effective antifungals is imperative, with plants standing out as promising sources of bioactive compounds. In the present study, we focus on the antibiofilm potential of Lavandula multifida essential oil (EO) against dermatophyte strains and Candida albicans. The EO was characterized using GC and GC-MS, and its antifungal effect was assessed on both biofilm formation and disruption. Biofilm mass, extracellular matrix, and viability were quantified using crystal violet, safranin, and XTT assays, respectively, and morphological alterations were confirmed using optical and scanning electron microscopy. L. multifida EO showed very high amounts of carvacrol and was very effective in inhibiting and disrupting fungal biofilms. The EO significantly decreased biofilm mass and viability in all tested fungi. In addition, a reduction in dermatophytes' extracellular matrix was observed, particularly during biofilm formation. Morphological alterations were evident in mature biofilms, with a clear decrease in hypha diameter. These promising results support the use of L. multifida EO in the development of effective plant-based antifungal products.
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Affiliation(s)
- Jorge Alves-Silva
- Univ Coimbra, Faculty of Pharmacy, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (J.A.-S.); (C.C.)
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3000-548 Coimbra, Portugal
- Clinical Academic Centre of Coimbra (CACC), 3004-561 Coimbra, Portugal
| | - Mónica Zuzarte
- Univ Coimbra, Faculty of Pharmacy, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (J.A.-S.); (C.C.)
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), 3000-548 Coimbra, Portugal
- Clinical Academic Centre of Coimbra (CACC), 3004-561 Coimbra, Portugal
| | - Carlos Cavaleiro
- Univ Coimbra, Faculty of Pharmacy, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (J.A.-S.); (C.C.)
- Univ Coimbra, Chemical Process Engineering and Forest Products Research Centre (CIEPQPF), Department of Chemical Engineering, Faculty of Sciences and Technology, Rua Sílvio Lima, 3030-790 Coimbra, Portugal
| | - Lígia Salgueiro
- Univ Coimbra, Faculty of Pharmacy, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (J.A.-S.); (C.C.)
- Univ Coimbra, Chemical Process Engineering and Forest Products Research Centre (CIEPQPF), Department of Chemical Engineering, Faculty of Sciences and Technology, Rua Sílvio Lima, 3030-790 Coimbra, Portugal
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14
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Zheng M, Zhou X, Pang J, Yang Z, Zou Y, Zhang L, Xu Y, Yin R. New methylene blue-mediated photodynamic inactivation of multidrug-resistant Fonsecaea nubica infected chromoblastomycosis in vitro. Braz J Microbiol 2023; 54:873-883. [PMID: 37145297 PMCID: PMC10234991 DOI: 10.1007/s42770-023-00974-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 04/10/2023] [Indexed: 05/06/2023] Open
Abstract
Chromoblastomycosis is a fungal disease presented with local warty papule, plaque, and verrucous nodules. In addition, the incidence and drug resistance of chromoblastomycosis are increasing each year worldwide. Photodynamic therapy is a promising method to treat mycoses. The purpose of this study was to evaluate the effect of new methylene blue (NMB)-induced PDT on multidrug-resistant chromoblastomycosis in vitro. We isolated one wild-type strain pathogen from one clinical patient diagnosed with chromoblastomycosis for over 27 years. The pathogen was identified by histopathology, the morphology of fungal culture, and genetic testing. Drug susceptibility testing was performed on the isolate. It was cultured with logarithmic growth phase spore in vitro and incubated with different concentrations of NMB for 30 min, and received illumination by red light-emitted diode with different light doses. After photodynamic treatment, the scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were conducted. The pathogen was Fonsecaea nubica, and it was resistant to itraconazole, terbinafine, amphotericin B, voriconazole andcaspofungin. At the same NMB concentration, the sterilization efficiency of NMB-photodynamic therapy (PDT) on F. nubica increased with increasing light intensity; F. nubica was completely killed at 25 µmol/L NMB with a light dose of 40 J/cm2 or 50 µmol/L NMB and light doses of ≥ 30 J/cm2. SEM and TEM observed ultrastructural changes after PDT. NMB-PDT inactivates the survival of multidrug-resistant F. nubica in vitro; it therefore has the potential to become an alternative or adjuvant treatment for refractory chromoblastomycosis.
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Affiliation(s)
- Mengxue Zheng
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xiaoqing Zhou
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Jiayin Pang
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Zengjun Yang
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Yongzhen Zou
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Lian Zhang
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Yan Xu
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Rui Yin
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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15
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Costa-Orlandi CB, Bila NM, Bonatti JLC, Vaso CO, Santos MB, Polaquini CR, Santoni Biasioli MM, Herculano RD, Regasini LO, Fusco-Almeida AM, Mendes-Giannini MJS. Membranolytic Activity Profile of Nonyl 3,4-Dihydroxybenzoate: A New Anti-Biofilm Compound for the Treatment of Dermatophytosis. Pharmaceutics 2023; 15:pharmaceutics15051402. [PMID: 37242644 DOI: 10.3390/pharmaceutics15051402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 05/28/2023] Open
Abstract
The ability of dermatophytes to live in communities and resist antifungal drugs may explain treatment recurrence, especially in onychomycosis. Therefore, new molecules with reduced toxicity that target dermatophyte biofilms should be investigated. This study evaluated nonyl 3,4-dihydroxybenzoate (nonyl) susceptibility and mechanism of action on planktonic cells and biofilms of T. rubrum and T. mentagrophytes. Metabolic activities, ergosterol, and reactive oxygen species (ROS) were quantified, and the expression of genes encoding ergosterol was determined by real-time PCR. The effects on the biofilm structure were visualized using confocal electron microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). T. rubrum and T. mentagrophytes biofilms were susceptible to nonyl and resistant to fluconazole, griseofulvin (all strains), and terbinafine (two strains). The SEM results revealed that nonyl groups seriously damaged the biofilms, whereas synthetic drugs caused little or no damage and, in some cases, stimulated the development of resistance structures. Confocal microscopy showed a drastic reduction in biofilm thickness, and transmission electron microscopy results indicated that the compound promoted the derangement and formation of pores in the plasma membrane. Biochemical and molecular assays indicated that fungal membrane ergosterol is a nonyl target. These findings show that nonyl 3,4-dihydroxybenzoate is a promising antifungal compound.
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Affiliation(s)
- Caroline B Costa-Orlandi
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (U.N.E.S.P.), Araraquara 14800-903, SP, Brazil
| | - Níura M Bila
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (U.N.E.S.P.), Araraquara 14800-903, SP, Brazil
- Department of Para-Clinic, School of Veterinary, Eduardo Modlane University (UEM), Maputo 257, Mozambique
| | - Jean Lucas C Bonatti
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (U.N.E.S.P.), Araraquara 14800-903, SP, Brazil
| | - Carolina O Vaso
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (U.N.E.S.P.), Araraquara 14800-903, SP, Brazil
| | - Mariana B Santos
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (U.N.E.S.P.), Sao Jose do Rio Preto 15054-000, SP, Brazil
| | - Carlos R Polaquini
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (U.N.E.S.P.), Sao Jose do Rio Preto 15054-000, SP, Brazil
| | - Mariana M Santoni Biasioli
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (U.N.E.S.P.), Araraquara 14800-903, SP, Brazil
| | - Rondinelli D Herculano
- Department of Bioprocesses and Biotechnology, School of Pharmaceutical Sciences, São Paulo State University (U.N.E.S.P.), Araraquara 14800-903, SP, Brazil
| | - Luis O Regasini
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (U.N.E.S.P.), Sao Jose do Rio Preto 15054-000, SP, Brazil
| | - Ana Marisa Fusco-Almeida
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (U.N.E.S.P.), Araraquara 14800-903, SP, Brazil
| | - Maria José S Mendes-Giannini
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (U.N.E.S.P.), Araraquara 14800-903, SP, Brazil
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16
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Song Y, Wang X, Li Q, Zhang R, de Hoog S, Li R. Fatal dermatophytic pseudomycetoma in a patient with non-HIV CD4 lymphocytopenia. Emerg Microbes Infect 2023; 12:2208685. [PMID: 37128909 DOI: 10.1080/22221751.2023.2208685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Dermatophytic pseudomycetoma is a rare invasive infection, involving both immunocompetent and immunocompromised individuals. Since the discovery of inherited immune disorders such as the impairment of CARD9 gene, extended dermatophyte infections are mostly ascribed to any of these host factors. This study is to present and explore the potential causes in a fatal dermatophytic pseudomycetoma patient. We present a chronic and deep pseudomycetoma caused by the common dermatophyte Microsporum canis which ultimately led to the death of the patient. Mycological examination, genetic studies and host immune responses against fungi were performed to explore the potential factors. The patient had decreased lymphocyte counts with significantly reduced CD4+ T cells, although all currently known genetic parameters proved to be normal. Through functional studies, we demonstrated that peripheral blood mononuclear cells from the patient showed severe impairment of adaptive cytokine production upon fungus-specific stimulation, whereas innate immune responses were partially defective. This is, to our knowledge, the first report of fatal dermatophytic pseudomycetoma in a patient with non-HIV CD4 lymphocytopenia, which highlights the importance of screening for immune deficiencies in patients with deep dermatophytosis.
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Affiliation(s)
- Yinggai Song
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Research Center for Medical Mycology, Peking University, Beijing, China
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
- Centre of Expertise for Mycology of Radboud University Medical Centre / Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Xiaowen Wang
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Research Center for Medical Mycology, Peking University, Beijing, China
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Qian Li
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
| | - Ruijun Zhang
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
| | - Sybren de Hoog
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
- Centre of Expertise for Mycology of Radboud University Medical Centre / Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Ruoyu Li
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Research Center for Medical Mycology, Peking University, Beijing, China
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
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17
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Alves-Silva JM, Maccioni D, Cocco E, Gonçalves MJ, Porcedda S, Piras A, Cruz MT, Salgueiro L, Maxia A. Advances in the Phytochemical Characterisation and Bioactivities of Salvia aurea L. Essential Oil. PLANTS (BASEL, SWITZERLAND) 2023; 12:1247. [PMID: 36986933 PMCID: PMC10056036 DOI: 10.3390/plants12061247] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/23/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
The Salvia L. genus (Lamiaceae) is largely used in the pharmaceutical and food industry. Several species of biological relevance are extensively employed in traditional medicine, including Salvia aurea L. (syn. S. africana-lutea L.), which is used as a traditional skin disinfectant and in wounds as a healing remedy; nevertheless, these properties have not been validated yet. The aim of the present study is to characterise S. aurea essential oil (EO), unveiling its chemical composition and validating its biological properties. The EO was obtained by hydrodistillation and subsequently analysed by GC-FID and GC-MS. Different biological activities were assessed: the antifungal effect on dermatophytes and yeasts and the anti-inflammatory potential by evaluating nitric oxide (NO) production and COX-2 and iNOS protein levels. Wound-healing properties were assessed using the scratch-healing test, and the anti-aging capacity was estimated through the senescence-associated beta-galactosidase activity. S. aurea EO is mainly characterised by 1,8-cineole (16.7%), β-pinene (11.9%), cis-thujone (10.5%), camphor (9.5%), and (E)-caryophyllene (9.3%). The results showed an effective inhibition of the growth of dermatophytes. Furthermore, it significantly reduced protein levels of iNOS/COX-2 and simultaneously NO release. Additionally, the EO exhibited anti-senescence potential and enhanced wound healing. Overall, this study highlights the remarkable pharmacological properties of Salvia aurea EO, which should be further explored in order to develop innovative, sustainable, and environmentally friendly skin products.
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Affiliation(s)
- Jorge Miguel Alves-Silva
- Institute for Clinical and Biomedical Research, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
| | - Delia Maccioni
- Laboratory of Plant Biology and Pharmaceutical Botany, Department of Life and Environmental Sciences, University of Cagliari, Viale Sant’Ignazio 13, 09123 Cagliari, Italy
| | - Emma Cocco
- Laboratory of Plant Biology and Pharmaceutical Botany, Department of Life and Environmental Sciences, University of Cagliari, Viale Sant’Ignazio 13, 09123 Cagliari, Italy
| | - Maria José Gonçalves
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Silvia Porcedda
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, Italy
| | - Alessandra Piras
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, Italy
| | - Maria Teresa Cruz
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Lígia Salgueiro
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Andrea Maxia
- Laboratory of Plant Biology and Pharmaceutical Botany, Department of Life and Environmental Sciences, University of Cagliari, Viale Sant’Ignazio 13, 09123 Cagliari, Italy
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18
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Alves-Silva JM, Gonçalves MJ, Silva A, Cavaleiro C, Cruz MT, Salgueiro L. Chemical Profile, Anti-Microbial and Anti-Inflammaging Activities of Santolina rosmarinifolia L. Essential Oil from Portugal. Antibiotics (Basel) 2023; 12:antibiotics12010179. [PMID: 36671380 PMCID: PMC9854695 DOI: 10.3390/antibiotics12010179] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/08/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
Fungal infections and the accompanying inflammatory responses are associated with great morbidity and mortality due to the frequent relapses triggered by an increased resistance to antifungal agents. Furthermore, this inflammatory state can be exacerbated during inflammaging and cellular senescence. Essential oils (EO) are receiving increasing interest in the field of drug discovery due to their lipophilic nature and complex composition, making them suitable candidates in the development of new antifungal drugs and modulators of numerous molecular targets. This work chemically characterized the EO from Santolina rosmarinifolia L., collected in Setúbal (Portugal), and assessed its antifungal potential by determining its minimum inhibitory (MIC) and minimum lethal (MLC) concentration in accordance with the Clinical Laboratory Standard Guidelines (CLSI) guidelines, as well as its effect on several Candida albicans virulence factors. The anti-inflammatory effect was unveiled using lipopolysaccharide (LPS)-stimulated macrophages by assessing several pro-inflammatory mediators. The wound healing and anti-senescence potential of the EO was also disclosed. The EO was mainly characterized by β-pinene (29.6%), borneol (16.9%), myrcene (15.4%) and limonene (5.7%). It showed a strong antifungal effect against yeasts and filamentous fungi (MIC = 0.07-0.29 mg/mL). Furthermore, it inhibited dimorphic transition (MIC/16), decreased biofilm formation with a preeminent effect after 24 h (MIC/2) and disrupted preformed biofilms in C. albicans. Additionally, the EO decreased nitric oxide (NO) release (IC50 = 0.52 mg/mL) and pro-IL-1β and inducible nitric oxide synthase (iNOS) expression in LPS-stimulated macrophages, promoted wound healing (91% vs. 81% closed wound) and reduced cellular senescence (53% vs. 73% β-galactosidase-positive cells). Overall, this study highlights the relevant pharmacological properties of S. rosmarinifolia, opening new avenues for its industrial exploitation.
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Affiliation(s)
- Jorge M. Alves-Silva
- Institute for Clinical and Biomedical Research, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
| | - Maria José Gonçalves
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3030-790 Coimbra, Portugal
| | - Ana Silva
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Carlos Cavaleiro
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3030-790 Coimbra, Portugal
| | - Maria Teresa Cruz
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Lígia Salgueiro
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3030-790 Coimbra, Portugal
- Correspondence:
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19
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Alves-Silva JM, Cocco E, Piras A, Gonçalves MJ, Silva A, Falconieri D, Porcedda S, Cruz MT, Maxia A, Salgueiro L. Unveiling the Chemical Composition and Biological Properties of Salvia cacaliifolia Benth. Essential Oil. PLANTS (BASEL, SWITZERLAND) 2023; 12:plants12020359. [PMID: 36679072 PMCID: PMC9867359 DOI: 10.3390/plants12020359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 05/14/2023]
Abstract
Salvia is widely recognized for its therapeutic potential. However, the biological relevance of some species remains unknown, namely Salvia cacaliifolia Benth. Therefore, the aim of this study is to unveil the chemical composition and relevant properties to its essential oil (EO). The EO was characterized by GC and GC-MS and its antifungal effect was evaluated according to the CLSI guidelines on dermatophytes and yeasts. The anti-inflammatory potential was assessed on lipopolysaccharide-stimulated macrophages, by assessing the production of nitric oxide (NO) and the effect on the protein levels of two key pro-inflammatory enzymes, iNOS and COX-2 by western blot analysis. Wound healing capacity was determined using the scratch wound healing assay, and the anti-aging potential was assessed by evaluating the senescence marker β-galactosidase. The EO was mainly characterized by γ-curcumene, β-bisabolene, bicyclogermacrene and curzerenone. It is effective in inhibiting the growth of dermatophytes and C. neoformans. The EO significantly decreased iNOS and COX-2 protein levels and concomitantly reduced NO release. Additionally, it demonstrated anti-senescence potential and promoted wound healing. Overall, this study highlights relevant pharmacological properties of the EO of Salvia cacaliifolia, which should be further explored envisaging the development of sustainable, innovative, and environmentally friendly skin products.
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Affiliation(s)
- Jorge M. Alves-Silva
- Institute for Clinical and Biomedical Research, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
| | - Emma Cocco
- Laboratory of Plant Biology and Pharmaceutical Botany, Department of Life and Environmental Sciences, University of Cagliari, Viale Sant’Ignazio, 09123 Cagliari, Italy
| | - Alessandra Piras
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, Italy
| | - Maria José Gonçalves
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3030-790 Coimbra, Portugal
| | - Ana Silva
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Danilo Falconieri
- Laboratory of Plant Biology and Pharmaceutical Botany, Department of Life and Environmental Sciences, University of Cagliari, Viale Sant’Ignazio, 09123 Cagliari, Italy
| | - Silvia Porcedda
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, Italy
| | - Maria Teresa Cruz
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Andrea Maxia
- Laboratory of Plant Biology and Pharmaceutical Botany, Department of Life and Environmental Sciences, University of Cagliari, Viale Sant’Ignazio, 09123 Cagliari, Italy
| | - Lígia Salgueiro
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3030-790 Coimbra, Portugal
- Correspondence:
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20
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Carmo PHF, Freitas GJC, Dornelas JCM, Almeida BCT, Baltazar LM, Ferreira GF, Peres NTA, Santos DA. Reactive oxygen and nitrogen species are crucial for the antifungal activity of amorolfine and ciclopirox olamine against the dermatophyte Trichophyton interdigitale. Med Mycol 2022; 60:6650890. [PMID: 35896502 DOI: 10.1093/mmy/myac058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/24/2022] [Accepted: 07/25/2022] [Indexed: 11/12/2022] Open
Abstract
Onychomycosis is a nail infection caused by Trichophyton interdigitale and other fungi, which can be treated with topical amorolfine (AMR) and ciclopirox olamine (CPX). Although these drugs are widely used, little is known about the role of reactive oxygen (ROS) and nitrogen (RNS) in their mechanism of action. Aiming to better understand the effects of AMR and CPX in dermatophytes, we evaluated whether they act through the production of ROS and peroxynitrite (PRN). We tested a set of strains, all susceptible to AMR and CPX, and these antifungals significantly reduced T. interdigitale viability within 24 hours. This effect occurred concomitantly with reduced ergosterol, increased production of ROS and PRN, and consequently increased lipid peroxidation. Together, these mechanisms lead to cell damage and fungal death. These fungicidal effects were abolished when PRN and superoxide scavengers were used in the assays, demonstrating the role of these species in the mechanism of action. We also studied the antioxidant system when T. interdigitale was exposed to AMR and CPX. Interestingly, superoxide dismutase and catalase inhibition lead to altered ROS and PRN production, lipid peroxidation, and ergosterol levels. In fact, the combination of AMR or CPX with a superoxide dismutase inhibitor was antagonistic. Together, these data demonstrate the importance of ROS and PRN in the antifungal action of AMR and CPX against the evaluated T. interdigitale strains.
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Affiliation(s)
- Paulo H F Carmo
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Gustavo J C Freitas
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - João C M Dornelas
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Bruna C T Almeida
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Ludmila M Baltazar
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Gabriella F Ferreira
- Programa Multicêntrico de Pós Graduação em Bioquímica e Biologia Molecular, Universidade Federal de Juiz de Fora, Rua São Paulo, 745, Centro, 35010-180, Governador Valadares, MG, Brazil
| | - Nalu T A Peres
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
| | - Daniel A Santos
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil
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21
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Ward H, Parkes N, Smith C, Kluzek S, Pearson R. Consensus for the Treatment of Tinea Pedis: A Systematic Review of Randomised Controlled Trials. J Fungi (Basel) 2022; 8:jof8040351. [PMID: 35448582 PMCID: PMC9027577 DOI: 10.3390/jof8040351] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: To systematically review literature enabling the comparison of the efficacy of pharmaceutical treatments for tinea pedis in adults. Design: Systematic review of randomised controlled trials (RCTs) with mycological cure as the primary outcome. Secondary outcomes did include the clinical assessment of resolving infection or symptoms, duration of treatment, adverse events, adherence, and recurrence. Eligibility Criteria: Study participants suffering from only tinea pedis that were treated with a pharmaceutical treatment. The study must have been conducted using an RCT study design and recording age of the participant > 16 years of age. Results: A total of seven studies met the inclusion criteria, involving 1042 participants. The likelihood of resolution in study participants treated with terbinafine was RR 3.9 (95% CI: 2.0−7.8) times those with a placebo. Similarly, the allylamine butenafine was effective by RR 5.3 (95% CI: 1.4−19.6) compared to a placebo. Butenafine was similarly efficacious to terbinafine RR 1.3 (95% CI: 0.4−4.4). Terbinafine was marginally more efficacious than itraconazole, RR 1.3 (95% CI: 1.1−1.5). Summary/Conclusion: Topical terbinafine and butenafine treatments of tinea pedis were more efficacious than placebo. Tableted terbinafine and itraconazole administered orally were efficacious in the drug treatment of tinea pedis fungal infection. We are concerned about how few studies were available that reported the baseline characteristics for each treatment arm and that did not suffer greater than 20% loss to follow-up. We would like to see improved reporting of clinical trials in academic literature. Registration name: Treatment’s for athlete’s foot—systematic review with meta-analysis [CRD42020162078].
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Affiliation(s)
- Harry Ward
- Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, University of Nottingham, Nottingham NG7 2UH, UK;
- Bodleian Health Care Libraries, Oxford University, Oxford OX3 9DU, UK;
- Correspondence:
| | - Nicholas Parkes
- Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, University of Nottingham, Nottingham NG7 2UH, UK;
- Bodleian Health Care Libraries, Oxford University, Oxford OX3 9DU, UK;
| | - Carolyn Smith
- Bodleian Health Care Libraries, Oxford University, Oxford OX3 9DU, UK;
| | - Stefan Kluzek
- Orthopaedics, Trauma and Sports Medicine, School of Medicine, Queen’s Medical, Centre University of Nottingham, Nottingham NG7 2UH, UK; (S.K.); (R.P.)
| | - Richard Pearson
- Orthopaedics, Trauma and Sports Medicine, School of Medicine, Queen’s Medical, Centre University of Nottingham, Nottingham NG7 2UH, UK; (S.K.); (R.P.)
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22
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Synthesis and Evaluation of the Antifungal and Toxicological Activity of Nitrofuran Derivatives. Pharmaceutics 2022; 14:pharmaceutics14030593. [PMID: 35335969 PMCID: PMC8950151 DOI: 10.3390/pharmaceutics14030593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/28/2022] [Accepted: 03/04/2022] [Indexed: 11/17/2022] Open
Abstract
Fungal diseases affect more than 1 billion people worldwide. The constant global changes, the advent of new pandemics, and chronic diseases favor the diffusion of fungal pathogens such as Candida, Cryptococcus, Aspergillus, Trichophyton, Histoplasma capsulatum, and Paracoccidioides brasiliensis. In this work, a series of nitrofuran derivatives were synthesized and tested against different fungal species; most of them showed inhibitory activity, fungicide, and fungistatic profile. The minimal inhibitory concentration (MIC90) values for the most potent compounds range from 0.48 µg/mL against H. capsulatum (compound 11) and P. brasiliensis (compounds 3 and 9) to 0.98 µg/mL against Trichophyton rubrum and T. mentagrophytes (compounds 8, 9, 12, 13 and 8, 12, 13, respectively), and 3.9 µg/mL against Candida and Cryptococcus neoformans strains (compounds 1 and 5, respectively). In addition, all compounds showed low toxicity when tested in vitro on lung cell lines (A549 and MRC-5) and in vivo in Caenorhabditis elegans larvae. Many of them showed high selectivity index values. Thus, these studied nitrofuran derivatives proved to be potent against different fungal species, characterized by low toxicity and high selectivity; for these reasons, they may become promising compounds for the treatment of mycoses.
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23
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Pathogenesis, Immunology and Management of Dermatophytosis. J Fungi (Basel) 2021; 8:jof8010039. [PMID: 35049979 PMCID: PMC8781719 DOI: 10.3390/jof8010039] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 12/31/2022] Open
Abstract
Dermatophytic infections of the skin and appendages are a common occurrence. The pathogenesis involves complex interplay of agent (dermatophytes), host (inherent host defense and host immune response) and the environment. Infection management has become an important public health issue, due to increased incidence of recurrent, recalcitrant or extensive infections. Recent years have seen a significant rise in incidence of chronic infections which have been difficult to treat. In this review, we review the literature on management of dermatophytoses and bridge the gap in therapeutic recommendations.
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24
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Zhou YB, Xiao YY, Chao JJ, Ma L. In vitro Activity of Allicin Alone and in Combination With Antifungal Drugs Against Microsporum canis Isolated From Patients With Tinea Capitis. Front Med (Lausanne) 2021; 8:783086. [PMID: 34901093 PMCID: PMC8660966 DOI: 10.3389/fmed.2021.783086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
The checkerboard broth method based on the Clinical and Laboratory Standards Institute M38-A3 document was used in this study to evaluate the in vitro activity of allicin alone and in combination with the antifungal drugs (griseofulvin, fluconazole, itraconazole and terbinafine) against Microsporum canis isolated from patients with tinea capitis. When allicin was used alone, only weak anti-M. canis effects were found. The MIC50, MIC90 and geometric mean (GM) of terbinafine were the lowest among the compounds tested. Synergism was observed for the combinations of allicin with itraconazole and terbinafine. Only indifference was observed for the combinations of allicin with griseofulvin and fluconazole. Our study illustrated the synergism of allicin in combination with itraconazole and terbinafine, which could be a reference for the treatment of tinea capitis due to M. canis.
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Affiliation(s)
- Ya Bin Zhou
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yuan Yuan Xiao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jin Jing Chao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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25
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Osman M, Kasir D, Rafei R, Kassem II, Ismail MB, El Omari K, Dabboussi F, Cazer C, Papon N, Bouchara JP, Hamze M. Trends in the epidemiology of dermatophytosis in the Middle East and North Africa region. Int J Dermatol 2021; 61:935-968. [PMID: 34766622 DOI: 10.1111/ijd.15967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/31/2021] [Accepted: 10/15/2021] [Indexed: 12/28/2022]
Abstract
Dermatophytosis corresponds to a broad series of infections, mostly superficial, caused by a group of keratinophilic and keratinolytic filamentous fungi called dermatophytes. These mycoses are currently considered to be a major public health concern worldwide, particularly in developing countries such as those in the Middle East and North Africa (MENA) region. Here we compiled and discussed existing epidemiologic data on these infections in the MENA region. Most of the available studies were based on conventional diagnostic strategies and were published before the last taxonomic revision of dermatophytes. This has led to misidentifications, which might have resulted in the underestimation of the real burden of these infections in the MENA countries. Our analysis of the available literature highlights an urgent need for further studies based on reliable diagnostic tools and standard susceptibility testing methods for dermatophytosis, which represents a major challenge for these countries. This is crucial for guiding appropriate interventions and activating antifungal stewardship programs in the future.
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Affiliation(s)
- Marwan Osman
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Dalal Kasir
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Rayane Rafei
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Issmat I Kassem
- Center for Food Safety and Department of Food Science and Technology, University of Georgia, Griffin, GA, USA
| | - Mohamad Bachar Ismail
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Faculty of Science, Lebanese University, Tripoli, Lebanon
| | - Khaled El Omari
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Quality Control Center Laboratories, Chamber of Commerce, Industry, and Agriculture of Tripoli and North Lebanon, Tripoli, Lebanon
| | - Fouad Dabboussi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Casey Cazer
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Nicolas Papon
- Univ Angers, Univ Brest, GEIHP, SFR ICAT, Angers, France
| | | | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
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26
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Mahajan A, Kaur L, Singh G, Dhawan RK, Singh L. Multipotentiality of Luliconazole against Various Fungal Strains: Novel Topical Formulations and Patent Review. RECENT ADVANCES IN ANTI-INFECTIVE DRUG DISCOVERY 2021; 16:182-195. [PMID: 34766898 DOI: 10.2174/2772434416666211111105854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/31/2021] [Accepted: 09/26/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Luliconazole is a broad-spectrum antifungal agent with impactful fungicidal and fungistatic activity. It has shown exceptional potency against miscellaneous fungal strains like Candida, Aspergillus, Malassezia, Fusarium species and various dermatophytes. OBJECTIVE Luliconazole belongs to class Ⅱ of the Biopharmaceutical Classification System with low aqueous solubility. Although it is available conventionally as 1% w/v topical cream, it has limitations of lower skin permeation and shorter skin retention. Therefore, nanoformulations based on various polymers and nanostructure carriers can be employed to overcome the impediments regarding topical delivery and efficacy of luliconazole. METHODS In this review, we have tried to provide insight into the literature gathered from authentic web resources and research articles regarding recent research conducted on the subject of formulation development, patents, and future research requisites of luliconazole. RESULTS Nanoformulations can play a fundamental role in improving topical delivery by escalating dermal localization and skin penetration. Fabricating luliconazole into nanoformulations can overcome the drawbacks and can efficiently enhance its antimycotic activity. CONCLUSION It has been concluded that luliconazole has exceptional potential in the treatment of various fungal infections, and therefore, it should be exploited to its maximum for its innovative application in the field of mycology.
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Affiliation(s)
- Ayushi Mahajan
- Department of Pharmaceutics, Khalsa College of Pharmacy, Amritsar, 143001, India
| | - Lakhvir Kaur
- Department of Pharmaceutics, Khalsa College of Pharmacy, Amritsar, 143001, India
| | - Gurjeet Singh
- Department of Pharmaceutics, Khalsa College of Pharmacy, Amritsar, 143001, India
| | - R K Dhawan
- Department of Pharmacology, Khalsa College of Pharmacy, Amritsar, 143001, India
| | - Lovepreet Singh
- Department of Pharmaceutics, Khalsa College of Pharmacy, Amritsar, 143001, India
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27
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Brescini L, Fioriti S, Morroni G, Barchiesi F. Antifungal Combinations in Dermatophytes. J Fungi (Basel) 2021; 7:jof7090727. [PMID: 34575765 PMCID: PMC8469868 DOI: 10.3390/jof7090727] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 12/19/2022] Open
Abstract
Dermatophytes are the most common cause of fungal infections worldwide, affecting millions of people annually. The emergence of resistance among dermatophytes along with the availability of antifungal susceptibility procedures suitable for testing antifungal agents against this group of fungi make the combinatorial approach particularly interesting to be investigated. Therefore, we reviewed the scientific literature concerning the antifungal combinations against dermatophytes. A literature search on the subject performed in PubMed yielded 68 publications: 37 articles referring to in vitro studies and 31 articles referring to case reports or clinical studies. In vitro studies involved over 400 clinical isolates of dermatophytes (69% Trichophyton spp., 29% Microsporum spp., and 2% Epidermophyton floccosum). Combinations included two antifungal agents or an antifungal agent plus another chemical compound including plant extracts or essential oils, calcineurin inhibitors, peptides, disinfectant agents, and others. In general, drug combinations yielded variable results spanning from synergism to indifference. Antagonism was rarely seen. In over 700 patients with documented dermatophyte infections, an antifungal combination approach could be evaluated. The most frequent combination included a systemic antifungal agent administered orally (i.e., terbinafine, griseofulvin, or azole-mainly itraconazole) plus a topical medication (i.e., azole, terbinafine, ciclopirox, amorolfine) for several weeks. Clinical results indicate that association of antifungal agents is effective, and it might be useful to accelerate the clinical and microbiological healing of a superficial infection. Antifungal combinations in dermatophytes have gained considerable scientific interest over the years and, in consideration of the interesting results available so far, it is desirable to continue the research in this field.
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Affiliation(s)
- Lucia Brescini
- Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, 60020 Ancona, Italy; (L.B.); (S.F.); (G.M.)
| | - Simona Fioriti
- Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, 60020 Ancona, Italy; (L.B.); (S.F.); (G.M.)
| | - Gianluca Morroni
- Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, 60020 Ancona, Italy; (L.B.); (S.F.); (G.M.)
| | - Francesco Barchiesi
- Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, 60020 Ancona, Italy; (L.B.); (S.F.); (G.M.)
- Malattie Infettive, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61121 Pesaro, Italy
- Correspondence: ; Tel.: +39-721-36-5505
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28
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Khalid A, Ahmed N, Qindeel M, Asad MI, Khan GM, Ur Rehman A. Development of novel biopolymer-based nanoparticles loaded cream for potential treatment of topical fungal infections. Drug Dev Ind Pharm 2021; 47:1090-1099. [PMID: 34279160 DOI: 10.1080/03639045.2021.1957914] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Biodegradable polymers are extensively used due to their efficient safety profiles. The aim of the current study was to fabricate, evaluate, and characterize biodegradable, biocompatible fluconazole (FLZ) loaded chitosan (CHS) chondroitin sulfate (CS) nanoparticles (NPs) for topical delivery. Polymers utilized in the formulation not only served as a carrier system but also aided in fighting with complex etiology of the disease due to their innate antifungal activities. METHODS NPs were prepared by the complex coacervation method, then were optimized for various parameters and subsequently loaded into a cream. RESULTS Scanning electron microscopic (SEM) analysis showed spherical morphology of the NPs. Prepared NPs showed an average particle size in the range of 350-450 nm and an encapsulation efficiency (EE) of 86%. The polydispersity index (PDI) was found to be 0.148 that showed a uniform distribution of NPs. Fourier transform infrared (FTIR) spectroscopy confirmed the absence of any electrostatic interaction between ingredients. In vitro drug release analyses exhibited a sustained release of the drug and higher antifungal activity than free FLZ. Ex vivo permeability and drug distribution in different skin layers ensured a site-specific delivery of the FLZ-NPs. As compared with free FLZ and other control groups, the prepared NPs also exhibited significantly higher antifungal activity against Candida albicans (p < .01). CONCLUSION It was concluded from the results that the FLZ-NPs laden cream could be a potential candidate for topical and site-specific delivery of the drug cargo for the potential treatment of fungal infections.
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Affiliation(s)
- Aimen Khalid
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Naveed Ahmed
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Maimoona Qindeel
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | | | - Gul Majid Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Asim Ur Rehman
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
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29
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Vitale RG, Giudicessi SL, Romero SM, Al-Hatmi AMS, Li Q, de Hoog GS. Recent developments in less known and multi-resistant fungal opportunists. Crit Rev Microbiol 2021; 47:762-780. [PMID: 34096817 DOI: 10.1080/1040841x.2021.1927978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Fungal infections have increased in recent years due to host factors, such as oncohaematological and transplant-related disorders, immunosuppressive therapy, and AIDS. Additionally, molecular and proteomic facilities have become available to identify previously unrecognizable opportunists. For these reasons, reports on less-known and recalcitrant mycoses, such as those caused by black fungi, hyaline filamentous fungi, coelomycetes, Mucorales, and non-Candida yeasts have emerged. In this review, novel taxonomy in these groups, which often are multi-resistant to one or several classes of antifungals, is discussed. Clinical presentations, diagnosis and current treatment of some major groups are summarised.
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Affiliation(s)
- Roxana G Vitale
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina.,Unidad de Parasitología, Sector Micología, Hospital J. M. Ramos Mejía, Buenos Aires, Argentina
| | - Silvana L Giudicessi
- Facultad de Farmacia y Bioquímica, Cátedra de Biotecnología, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Nanobiotecnología (NANOBIOTEC), UBA-CONICET, Buenos Aires, Argentina
| | - Stella M Romero
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina.,Instituto Multidisciplinario de Biología Vegetal (IMBIV), CONICET, FCEFyN, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Abdullah M S Al-Hatmi
- Center of Expertise in Mycology of Radboud, University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.,Natural & Medical Science Research Center, University of Nizwa, Nizwa, Omán
| | - Qirui Li
- Department of Pharmacy, Guiyang Medical University, Guiyang, PR China
| | - G Sybren de Hoog
- Center of Expertise in Mycology of Radboud, University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.,Key Laboratory of Environmental Pollution Monitoring and Disease Control, School of Basic Medical Sciences, Guizhou Medical University, Guiyang, PR China.,Department of Medical Microbiology, People's Hospital of Suzhou, National New & Hi-Tech Industrial Development Zone, Suzhou, PR China
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30
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Lopes AI, Tavaria FK, Pintado ME. Conventional and natural compounds for the treatment of dermatophytosis. Med Mycol 2021; 58:707-720. [PMID: 31773153 DOI: 10.1093/mmy/myz116] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/16/2019] [Accepted: 10/31/2019] [Indexed: 01/22/2023] Open
Abstract
Dermatophytes are a group of pathogenic fungi that exclusively infect the stratum corneum of the skin, nails, and hair, causing dermatophytosis. Superficial skin infections caused by dermatophytes have increased in the last decades. There are conventional antifungals that treat these infections, such as terbinafine, fluconazole, and others. However, the limitations of these treatments (resistance, side effects and toxicity) along with the increasing over-prescription, the misuse of these antifungals and the high treatment costs led to the search for new, alternative, natural-based antifungal drugs. These have multiple mechanisms of action, which works to their advantage, making it difficult for a fungus to create resistance mechanisms against all of them at the same time. The main objective of this work is to provide a state-of-the-art review on dermatophytes, dermatophytosis, and the existing treatments, both conventional and natural, such as chitosan and essential oils.
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Affiliation(s)
- Ana I Lopes
- Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua de Diogo Botelho, 1327, 4169-005 Porto, Portugal
| | - Freni K Tavaria
- Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua de Diogo Botelho, 1327, 4169-005 Porto, Portugal
| | - Manuela E Pintado
- Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua de Diogo Botelho, 1327, 4169-005 Porto, Portugal
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31
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Bila NM, Costa-Orlandi CB, Vaso CO, Bonatti JLC, de Assis LR, Regasini LO, Fontana CR, Fusco-Almeida AM, Mendes-Giannini MJS. 2-Hydroxychalcone as a Potent Compound and Photosensitizer Against Dermatophyte Biofilms. Front Cell Infect Microbiol 2021; 11:679470. [PMID: 34055673 PMCID: PMC8155603 DOI: 10.3389/fcimb.2021.679470] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/23/2021] [Indexed: 12/15/2022] Open
Abstract
Dermatophytes, fungi that cause dermatophytosis, can invade keratinized tissues in humans and animals. The biofilm-forming ability of these fungi was described recently, and it may be correlated with the long treatment period and common recurrences of this mycosis. In this study, we evaluated the anti-dermatophytic and anti-biofilm activity of 2-hydroxychalcone (2-chalcone) in the dark and photodynamic therapy (PDT)-mediated and to determine its mechanism of action. Trichophyton rubrum and Trichophyton mentagrophytes strains were used in the study. The antifungal susceptibility test of planktonic cells, early-stage biofilms, and mature biofilms were performed using colorimetric methods. Topographies were visualized by scanning electron microscopy (SEM). Human skin keratinocyte (HaCat) monolayers were also used in the cytotoxicity assays. The mechanisms of action of 2-chalcone in the dark and under photoexcitation were investigated using confocal microscopy and the quantification of ergosterol, reactive oxygen species (ROS), and death induction by apoptosis/necrosis. All strains, in the planktonic form, were inhibited after treatment with 2-chalcone (minimum inhibitory concentration (MIC) = 7.8-15.6 mg/L), terbinafine (TRB) (MIC = 0.008–0.03 mg/L), and fluconazole (FLZ) (1–512 mg/L). Early-stage biofilm and mature biofilms were inhibited by 2-chalcone at concentrations of 15.6 mg/L and 31.2 mg/L in all tested strains. However, mature biofilms were resistant to all the antifungal drugs tested. When planktonic cells and biofilms (early-stage and mature) were treated with 2-chalcone-mediated PDT, the inhibitory concentrations were reduced by four times (2–7.8 mg/L). SEM images of biofilms treated with 2-chalcone showed cell wall collapse, resulting from a probable extravasation of cytoplasmic content. The toxicity of 2-chalcone in HaCat cells showed higher IC50 values in the dark than under photoexcitation. Further, 2-chalcone targets ergosterol in the cell and promotes the generation of ROS, resulting in cell death by apoptosis and necrosis. Overall, 2-chalcone-mediated PDT is a promising and safe drug candidate against dermatophytes, particularly in anti-biofilm treatment.
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Affiliation(s)
- Níura Madalena Bila
- Department of Clinical Analysis, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil.,Department of Para-Clinic, School of Veterinary, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique
| | - Caroline Barcelos Costa-Orlandi
- Department of Clinical Analysis, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Carolina Orlando Vaso
- Department of Clinical Analysis, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Jean Lucas Carvalho Bonatti
- Department of Clinical Analysis, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Letícia Ribeiro de Assis
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, Universidade Estadual Paulista (UNESP), Sao Jose do Rio Preto, Brazil
| | - Luís Octavio Regasini
- Department of Chemistry and Environmental Sciences, Institute of Biosciences, Humanities and Exact Sciences, Universidade Estadual Paulista (UNESP), Sao Jose do Rio Preto, Brazil
| | - Carla Raquel Fontana
- Department of Clinical Analysis, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Ana Marisa Fusco-Almeida
- Department of Clinical Analysis, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
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32
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Shamsizadeh F, Ansari S, Zarei Mahmoudabadi A, Hubka V, Čmoková A, Guillot J, Rafiei A, Zomorodian K, Nouripour-Sisakht S, Diba K, Mohammadi T, Zarrinfar H, Rezaei-Matehkolaei A. In vitro antifungal susceptibility patterns of Trichophyton benhamiae complex isolates from diverse origin. Mycoses 2021; 64:1378-1386. [PMID: 33864711 DOI: 10.1111/myc.13287] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Species from the Trichophyton benhamiae complex are mostly zoophilic dermatophytes which cause inflammatory dermatophytosis in animals and humans worldwide. OBJECTIVES This study was purposed to (a) to identify 169 reference and clinical dermatophyte strains from the T benhamiae complex species by molecular method and adhering to the newest taxonomy in the complex (b) to evaluate the in vitro antifungal susceptibility profile of these strains against eight common and new antifungal agents that may be used for the treatment of dermatophytosis. METHODS All isolates, mainly originated from Europe but also from Iran, Japan and USA, were subjected to ITS-rDNA sequencing. The in vitro antifungal susceptibility profiles of eight common and new antifungal drugs against the isolates were determined by CLSI M38-A2 protocol and according to microdilution method. RESULTS Based on the ITS-rDNA sequencing, T benhamiae was the dominant species (n = 102), followed by T europaeum (n = 29), T erinacei (n = 23), T japonicum (n = 10), Trichophyton sp (n = 4) and T eriotrephon (n = 1). MIC ranges across all isolates were as follows: luliconazole: 0.0002-0.002 µg/ml, terbinafine: 0.008-0.125 µg/ml, efinaconazole: 0.008-0.125 µg/ml, ciclopirox olamine: 0.03-0.5 µg/ml, itraconazole: 0.06-2 µg/ml, griseofulvin: 0.25-4 µg/ml, amorolfine hydrochloride: 0.125-4 µg/ml and tavaborole: 1-16 µg/ml. CONCLUSION Luliconazole, efinaconazole and terbinafine were the most potent antifungals against T benhamiae complex isolates, regardless of the geographic locations where strains were isolated. These data might help dermatologists to develop effective therapies for successful treatment of infections due to T benhamiae complex species.
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Affiliation(s)
- Forough Shamsizadeh
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saham Ansari
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Zarei Mahmoudabadi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Vít Hubka
- Department of Botany, Faculty of Science, Charles University, Prague, Czech Republic.,Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology, Czech Academy of Sciences, Vídeňská, Czech Republic
| | - Adéla Čmoková
- Department of Botany, Faculty of Science, Charles University, Prague, Czech Republic.,Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology, Czech Academy of Sciences, Vídeňská, Czech Republic
| | - Jacques Guillot
- Dynamic Research Group UPEC, EnvA, USC Anses, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Abdollah Rafiei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Medical Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kamiar Zomorodian
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Kambiz Diba
- Department of Medical Mycology and Parasitology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Tooba Mohammadi
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Rezaei-Matehkolaei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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33
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Makvandi P, Josic U, Delfi M, Pinelli F, Jahed V, Kaya E, Ashrafizadeh M, Zarepour A, Rossi F, Zarrabi A, Agarwal T, Zare EN, Ghomi M, Kumar Maiti T, Breschi L, Tay FR. Drug Delivery (Nano)Platforms for Oral and Dental Applications: Tissue Regeneration, Infection Control, and Cancer Management. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:2004014. [PMID: 33898183 PMCID: PMC8061367 DOI: 10.1002/advs.202004014] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/12/2020] [Indexed: 05/09/2023]
Abstract
The oral cavity and oropharynx are complex environments that are susceptible to physical, chemical, and microbiological insults. They are also common sites for pathological and cancerous changes. The effectiveness of conventional locally-administered medications against diseases affecting these oral milieus may be compromised by constant salivary flow. For systemically-administered medications, drug resistance and adverse side-effects are issues that need to be resolved. New strategies for drug delivery have been investigated over the last decade to overcome these obstacles. Synthesis of nanoparticle-containing agents that promote healing represents a quantum leap in ensuring safe, efficient drug delivery to the affected tissues. Micro/nanoencapsulants with unique structures and properties function as more favorable drug-release platforms than conventional treatment approaches. The present review provides an overview of newly-developed nanocarriers and discusses their potential applications and limitations in various fields of dentistry and oral medicine.
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Affiliation(s)
- Pooyan Makvandi
- Chemistry Department, Faculty of ScienceShahid Chamran University of AhvazAhvaz6153753843Iran
| | - Uros Josic
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaVia San Vitale 59Bologna40125Italy
| | - Masoud Delfi
- Department of Chemical SciencesUniversity of Naples “Federico II”Complesso Universitario Monte S. Angelo, Via CintiaNaples80126Italy
| | - Filippo Pinelli
- Department of Chemistry, Materials and Chemical EngineeringPolitecnico di Milano Technical UniversityMilano20133Italy
| | - Vahid Jahed
- Biomedical Engineering Division, Faculty of Chemical EngineeringTarbiat Modares UniversityTehranIran
| | - Emine Kaya
- Faculty of DentistryIstanbul Okan UniversityTuzla CampusTuzlaIstanbul34959Turkey
| | - Milad Ashrafizadeh
- Faculty of Engineering and Natural SciencesSabanci UniversityOrta Mahalle, Üniversite Caddesi No. 27, OrhanlıTuzlaIstanbul34956Turkey
- Sabanci University Nanotechnology Research and Application Center (SUNUM)TuzlaIstanbul34956Turkey
| | - Atefeh Zarepour
- Sabanci University Nanotechnology Research and Application Center (SUNUM)TuzlaIstanbul34956Turkey
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical EngineeringPolitecnico di Milano Technical UniversityMilano20133Italy
| | - Ali Zarrabi
- Sabanci University Nanotechnology Research and Application Center (SUNUM)TuzlaIstanbul34956Turkey
| | - Tarun Agarwal
- Department of BiotechnologyIndian Institute of Technology KharagpurKharagpurWest Bengal721302India
| | | | - Matineh Ghomi
- Chemistry Department, Faculty of ScienceShahid Chamran University of AhvazAhvaz6153753843Iran
| | - Tapas Kumar Maiti
- Department of BiotechnologyIndian Institute of Technology KharagpurKharagpurWest Bengal721302India
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaVia San Vitale 59Bologna40125Italy
| | - Franklin R Tay
- The Dental College of GeorgiaAugusta University1430 John Wesley Gilbert DriveAugustaGA30192USA
- The Graduate SchoolAugusta UniversityAugustaGA30912USA
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34
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Polk C, Sampson MM, Roshdy D, Davidson LE. Skin and Soft Tissue Infections in Patients with Diabetes Mellitus. Infect Dis Clin North Am 2020; 35:183-197. [PMID: 33303332 DOI: 10.1016/j.idc.2020.10.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Skin and soft tissue infections are common in diabetics. Diabetic foot infection usually results from disruption of the skin barrier, trauma, pressure, or ischemic wounds. These wounds may become secondarily infected or lead to development of adjacent soft tissue or deeper bone infection. Clinical assessment and diagnosis of these conditions using a multidisciplinary management approach, including careful attention to antibiotic selection, lead to the best outcomes in patient care.
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Affiliation(s)
- Christopher Polk
- Division of Infectious Diseases, Department of Medicine, Atrium Health, Charlotte, NC, USA
| | - Mindy M Sampson
- Division of Infectious Diseases, Department of Medicine, Atrium Health, Charlotte, NC, USA
| | - Danya Roshdy
- Antimicrobial Support Network, Division of Pharmacy, Atrium Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA
| | - Lisa E Davidson
- Division of Infectious Diseases, Department of Medicine, Atrium Health, 1540 Garden Terrace, Suite 211, Charlotte, NC 28203, USA.
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35
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Ansari S, Ahmadi B, Hedayati MT, Nouripour-Sisakht S, Taghizadeh-Armaki M, Fathi M, Deravi N, Shokoohi GR, Rezaei-Matehkolaei A. Investigation of in vitro antifungal susceptibility testing and genetic diversity of clinical isolates of Trichophyton benhamiae and Trichophyton eriotrephon in Iran. Mycoses 2020; 64:316-323. [PMID: 33190353 DOI: 10.1111/myc.13210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/12/2020] [Accepted: 11/08/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Trichophyton benhamiae is a zoophilic dermatophyte, known as one of the causative agents of dermatophytosis. OBJECTIVES The purpose of this study was to explore the genotypes of T. benhamiae strains isolated from geographically different areas of Iran and also to evaluate in vitro antifungal susceptibility profile of these strains against seven antifungal drugs. METHODS Twenty-two strains of T. benhamiae and two strains of T. eriotrephon were isolated from patients with distinct types of dermatophytosis. DNA extraction and amplification of rDNA regions using ITS1 and ITS4 primers were conducted on the isolates. The in vitro antifungal susceptibility of posaconazole (PSC), voriconazole (VRC), itraconazole (ITC), ketoconazole (KET), caspofungin (CAS), terbinafine (TRB) and griseofulvin (GRZ) was evaluated according to CLSI M38-A2 protocol. RESULTS The multiple alignment of the ITS-rDNA sequences of T. benhamiae indicated a mean similarity of 99.5%, with 0-3 interspecies nucleotide difference. The geometric mean (GM) values of minimum inhibitory concentrations (MICs) and minimum effective concentrations (MECs) across the all isolates were respectively: TRB: 0.025 mg/L, PSC: 0.032 mg/L, ITC: 0.050 mg/L and VRC: 0.059 mg/L with lower values and CAS: 0.31 mg/L, KTZ: 0.56 mg/L and GRZ: 0.76 mg/L with higher values. CONCLUSION Diverse ITS sequence types of T. benhamiae were shown in different geographical regions of Iran. The TRB, PSC and ITC were the most effective drugs against T. benhamiae strains, respectively. Furthermore, in our study, two strains of T. eriotrephon as a scarce dermatophyte species were described.
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Affiliation(s)
- Saham Ansari
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Ahmadi
- Department of Medical Laboratory Sciences, School of Para-Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammad T Hedayati
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mojtaba Taghizadeh-Armaki
- Department of Medical Parasitology and Mycology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mobina Fathi
- Medical Student Research, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Deravi
- Medical Student Research, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholam-Reza Shokoohi
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ali Rezaei-Matehkolaei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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36
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Musavi Bafrui N, Hashemi Hazaveh SJ, Bayat M. In-Vitro Activity of Nano Fluconazole and Conventional Fluconazole against Clinically Important Dermatophytes. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1970-1976. [PMID: 33346221 PMCID: PMC7719649 DOI: 10.18502/ijph.v49i10.4701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Dermatophytosis is one of the most common fungal infections in humans. Antifungals such as fluconazole are effectively used for treating dermatophytosis; however, drug resistance was observed in many cases. Therefore, a newer treatment strategy is essential. Methods: This study (Conducted in the Laboratory of the School of Public Health, Tehran University of Medical Sciences, Tehran, Iran in 2018) evaluated the antifungal susceptibility of nano fluconazole compared to conventional fluconazole on dermatophyte isolates using CLSI M38-A2guidelines. Dermatophyte species isolated from clinical cases of dermatophytosis were identified using PCR sequencing techniques. Zeta potential and size of the nano particles containing fluconazole were measured; scanning electron microscope (SEM) was used to determine nano particle structure. Results: The size of liposomal fluconazole obtained was 88.9 ± 12.14 nm with –20.12 ± 3.8 mV for zeta potential. The encapsulation rate for fluconazole was 75.1± 4.2%. MIC50 for the three tested species was 32, 16, and 8 μg/ml for Trichophyton interdigitale, T. rubrum, and Epidermophyton floccosum isolates, respectively. The corresponding values for nano fluconazole were 8 μg/ml for the three tested species. Conclusion: MIC value for nano-fluconazole was lower than conventional fluconazole in all dermatophytes species tested; therefore, nano-fluconazole could inhibit the growth of dermatophytes better than fluconazole at a lower concentration of the drug.
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Affiliation(s)
- Najmossadat Musavi Bafrui
- Department of Microbiology, Faculty of Veterinary Specialized Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Seyed Jamal Hashemi Hazaveh
- Department of Microbiology, Faculty of Veterinary Specialized Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.,Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Bayat
- Department of Microbiology, Faculty of Veterinary Specialized Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
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37
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Pan T, Liu X, Liu C, Li J, Ma W, Qin Y, Chen Y, Lin S, Ye F. Evaluation of the photodynamic efficacy and effects of haematoporphyrin monomethyl ether on Trichophyton rubrum microconidia in vitro. Mycoses 2020; 63:1215-1225. [PMID: 32783251 DOI: 10.1111/myc.13149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/27/2020] [Accepted: 07/17/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Current available treatment modes against dermatophytoses are often tedious and sometimes unsatisfactory. As an emerging and promising approach, antimicrobial photodynamic therapy (aPDT) attracts much attention in the treatment of superficial or localised infections. OBJECTIVES This work investigated the photodynamic efficacy and effects of haematoporphyrin monomethyl ether (HMME) on microconidia of Trichophyton rubrum in vitro. METHODS The photodynamic killing efficacy of HMME on microconidia of two T rubrum strains was assessed by MTT assay. The effects of HMME-mediated aPDT on the growth of T rubrum and cellular structure of microconidia were also investigated. Confocal laser scanning microscopy (CLSM) and flow cytometry were employed to study the intracellular localisation of HMME and generation of reactive oxygen species (ROS). RESULTS HMME showed no obvious toxicity in the dark, but after light irradiation it inactivated the T rubrum microconidia in a light energy dose-dependent manner, and inhibited the growth of T rubrum. CLSM demonstrated that HMME initially bound to the cell envelop and entered into the cell after light irradiation. HMME-mediated aPDT also damaged the cell cytoplasm and increased the accumulation of intracellular ROS, resulting in cell death. CONCLUSIONS The results suggested that HMME-mediated aPDT had potential to be used in the treatment of superficial infections caused by T rubrum.
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Affiliation(s)
- Tiantian Pan
- Department of Infection, The First Affiliated Hospital of College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiaojing Liu
- Department of Infection, The First Affiliated Hospital of College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - Chengcheng Liu
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, PR China
| | - Jiao Li
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, PR China
| | - Wenpeng Ma
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, PR China
| | - Yannan Qin
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, PR China
| | - Yunru Chen
- Department of Infection, The First Affiliated Hospital of College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - Shumei Lin
- Department of Infection, The First Affiliated Hospital of College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - Feng Ye
- Department of Infection, The First Affiliated Hospital of College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
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38
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Aleohin N, Bar J, Bar-Ilan E, Samuelov L, Sprecher E, Mashiah J. Laboratory monitoring during antifungal treatment of paediatric tinea capitis. Mycoses 2020; 64:157-161. [PMID: 33064847 DOI: 10.1111/myc.13197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/27/2020] [Accepted: 10/05/2020] [Indexed: 12/23/2022]
Abstract
Griseofulvin and terbinafine are considered effective first-line therapies for tinea capitis (TC). Haematological dyscrasias and hepatic injury are possible adverse effects with both drugs. There is a debate in the literature regarding the necessity of laboratory monitoring during griseofulvin and terbinafine treatment. We aimed at assessing the prevalence and severity of haematological and hepatic laboratory test abnormalities in a paediatric cohort of African immigrants in Tel-Aviv with TC who were treated with Terbinafine or Griseofulvin. We conducted a retrospective study of all TC cases diagnosed and treated at the paediatric dermatology clinic, Tel-Aviv Medical centre, between June 2013 and March 2019. Epidemiologic, clinical and laboratory data were collected. Our cohort included 321 patients of whom 225 (70%) were treated with Griseofulvin and 96 (30%) with Terbinafine. We identified a total of 64 (20%) patients with haematological or hepatic laboratory test abnormalities that in most cases (96.3%) were considered as mild. No difference in laboratory abnormalities prevalence was identified between the griseofulvin and terbinafine groups (21.3% and 16.6%, respectively). Only one patient treated with Griseofulvin revealed significantly increased levels of hepatic aminotransferases that required discontinuation of treatment. Mild elevation in hepatic transaminases is relatively common among paediatric patients treated with systemic antifungal treatment for TC. However, significant laboratory abnormalities are extremely rare and may be diagnosed and addressed early through periodic laboratory tests monitoring.
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Affiliation(s)
- Natalie Aleohin
- Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Jonathan Bar
- Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Efrat Bar-Ilan
- Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Liat Samuelov
- Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Pediatric Dermatology Clinic, Tel-Aviv Sourasky Medical Center, Dana-Dwek Children's Hospital, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eli Sprecher
- Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Pediatric Dermatology Clinic, Tel-Aviv Sourasky Medical Center, Dana-Dwek Children's Hospital, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jacob Mashiah
- Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Pediatric Dermatology Clinic, Tel-Aviv Sourasky Medical Center, Dana-Dwek Children's Hospital, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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39
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Lengert EV, Talnikova EE, Tuchin VV, Svenskaya YI. Prospective Nanotechnology-Based Strategies for Enhanced Intra- and Transdermal Delivery of Antifungal Drugs. Skin Pharmacol Physiol 2020; 33:261-269. [PMID: 33091913 DOI: 10.1159/000511038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 08/20/2020] [Indexed: 11/19/2022]
Abstract
Topical therapy of superficial fungal infections allows the prevention of systemic side effects and provides drug targeting at the site of disease. However, an appropriate drug concentration in these sites should be provided to ensure the efficacy of such local treatment. The enhancement of intra- and transdermal penetration and accumulation of antifungal drugs is an important aspect here. The present overview is focused on novel nano-based formulations served to improve antimycotic penetration through the skin. Furthermore, it summarizes various approaches towards the stimulation of drug penetration through and into the stratum corneum and hair follicles, which are considered to be promising for the future improvement of superficial antifungal therapy as providing the drug localization and prolonged storage property at the targeted area.
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Affiliation(s)
- Ekaterina V Lengert
- Educational and Research Institute of Nanostructures and Biosystems, Saratov State University, Saratov, Russian Federation,
| | - Ekaterina E Talnikova
- Department of Dermatovenereology and Cosmetology, Saratov State Medical University, Saratov, Russian Federation
| | - Valery V Tuchin
- Research-Educational Institute of Optics and Biophotonics, Saratov State University, Saratov, Russian Federation.,Interdisciplinary Laboratory of Biophotonics, National Research Tomsk State University, Tomsk, Russian Federation
| | - Yulia I Svenskaya
- Educational and Research Institute of Nanostructures and Biosystems, Saratov State University, Saratov, Russian Federation
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40
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Kermani F, Javidnia J, Hedayati MT, Abastabar M, Haghani I, Didehdar M, Fami Zaghrami M, Shokohi T. In vitro activities of antifungal drugs against a large collection of Trichophyton tonsurans isolated from wrestlers. Mycoses 2020; 63:1321-1330. [PMID: 32854165 DOI: 10.1111/myc.13172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Trichophyton tonsurans is the most common agent causing tinea gladiatorum in wrestlers, and limited data on susceptibility profiles of Trichophyton tonsurans are available. OBJECTIVES We aimed to assess the in vitro activity of the common antifungal drug against a large collection of T tonsurans. MATERIALS/METHODS The in vitro activities to eight common antifungal drugs (sertaconazole, itraconazole, clotrimazole, fluconazole, butenafine, tolnaftate, terbinafine and griseofulvin) against 128 clinical isolates of T tonsurans strains, obtained from wrestlers with dermatophytosis, were performed according to CLSI M38-A2 broth microdilution document. RESULTS The geometric mean minimum inhibitory concentration was the lowest for tolnaftate (0.022 µg/mL), followed by itraconazole (0.026 µg/mL), terbinafine (0.033 µg/mL), butenafine (0.088 µg/mL), griseofulvin (0.566 µg/mL), sertaconazole (2.875 µg/mL), clotrimazole (3.419 µg/mL) and fluconazole (12.540 µg/mL). CONCLUSIONS Evaluation of antifungal susceptibility of dermatophytes showed that tolnaftate and itraconazole were the most effective drugs against T tonsurans and fluconazole had the least effect.
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Affiliation(s)
- Firoozeh Kermani
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Javad Javidnia
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad T Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mojtaba Didehdar
- Department of Medical Mycology and Parasitology, Arak University of Medical Sciences, Arak, Iran
| | | | - Tahereh Shokohi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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41
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Trottier CA, Jhaveri VV, Zimarowski MJ, Blair BM, Alonso CD. Beyond the Superficial: Disseminated Trichophyton rubrum Infection in a Kidney Transplant Recipient. Open Forum Infect Dis 2020; 7:ofaa281. [PMID: 33094122 PMCID: PMC7566364 DOI: 10.1093/ofid/ofaa281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/01/2020] [Indexed: 12/02/2022] Open
Abstract
Superficial dermatophyte infections are common in the general population and are readily treated with topical antifungals. Deeper invasion is rare, and dissemination to visceral organs is extremely uncommon. We describe a 66-year-old renal transplant recipient who developed disseminated Trichophyton rubrum infection while undergoing treatment for acute humoral rejection. The infection presented as a facial rash with subsequent dissemination to the lungs and chest wall. All sites of infection improved with combination administration of oral posaconazole and terbinafine. In this work, we review the available literature regarding management of disseminated Trichophyton infection and discuss therapeutic interventions for disseminated dermatophytosis in immunosuppressed hosts.
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Affiliation(s)
- Caitlin A Trottier
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Vimal V Jhaveri
- Harvard Medical School, Boston, Massachusetts, USA.,Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Mary Jane Zimarowski
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Barbra M Blair
- Harvard Medical School, Boston, Massachusetts, USA.,Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Carolyn D Alonso
- Harvard Medical School, Boston, Massachusetts, USA.,Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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42
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Najafzadeh MJ, Dolatabadi S, de Hoog S, Esfahani MK, Haghani I, Aghili SR, Ghazvini RD, Rezaei-Matehkolaei A, Abastabar M, Al-Hatmi AMS. Phylogenetic Analysis of Clinically Relevant Fusarium Species in Iran. Mycopathologia 2020; 185:515-525. [PMID: 32506392 DOI: 10.1007/s11046-020-00460-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 05/22/2020] [Indexed: 10/20/2022]
Abstract
Fungi of the genus Fusarium are well known as major plant pathogens but also cause a broad spectrum of human infections. Sixty-three clinical isolates, collected during 2014-2017, were identified using a part of the TEF1 gene as barcoding marker. Fusarium fujikuroi species complex (FFSC, n = 41, 65%) showed to be the dominant etiological agent, followed by F. solani species complex (FSSC, n = 14, 22%) and F. oxysporum species complex (FOSC, n = 7, 11%). There was one strain belonging to F. lateritium species complex (FLSC, n = 1, 1.5%). For final identification, a phylogenetic tree was constructed including the type strains of each species complex. Most cases of fusariosis were due to nail infection (n = 38, 60.3%), followed by keratitis (n = 22, 34%). Fusarium infections are difficult to be treated due to their intrinsic resistance to different azoles; however, accurate and fast identification of etiological agents may enhance management of the infection. We present the first phylogenetic study on clinical Fusarium spp. from Iran.
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Affiliation(s)
- Mohammad Javad Najafzadeh
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somayeh Dolatabadi
- Faculty of Engineering, Sabzevar University of New Technology, Sabzevar, Iran
| | - Sybren de Hoog
- Center of Expertise in Mycology of Radboud University Medical Center, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.,Foundation Atlas of Clinical Fungi, Hilversum, The Netherlands
| | - Mahmoud Karimizadeh Esfahani
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Iman Haghani
- Invasive Fungi Research Center (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Reza Aghili
- Invasive Fungi Research Center (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roshanak Daei Ghazvini
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rezaei-Matehkolaei
- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Abdullah M S Al-Hatmi
- Center of Expertise in Mycology of Radboud University Medical Center, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. .,Foundation Atlas of Clinical Fungi, Hilversum, The Netherlands. .,Ministry of Health, Directorate General of Health Services, Ibri, Oman.
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43
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Costa-Orlandi CB, Serafim-Pinto A, da Silva PB, Bila NM, Bonatti JLDC, Scorzoni L, Singulani JDL, Dos Santos CT, Nazaré AC, Chorilli M, Regasini LO, Fusco-Almeida AM, Mendes-Giannini MJS. Incorporation of Nonyl 3,4-Dihydroxybenzoate Into Nanostructured Lipid Systems: Effective Alternative for Maintaining Anti-Dermatophytic and Antibiofilm Activities and Reducing Toxicity at High Concentrations. Front Microbiol 2020; 11:1154. [PMID: 32582096 PMCID: PMC7290161 DOI: 10.3389/fmicb.2020.01154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/06/2020] [Indexed: 12/18/2022] Open
Abstract
Dermatophytosis is the most common mycosis worldwide, affecting approximately 20 to 25% of the population, regardless of gender, race, color, and age. Most antifungal agents used for the treatment of dermatophytosis belong to the azole and allylamine classes. Dermatophytes are reported to be resistant to most commercial drugs, especially microbial biofilms, in addition to their considerable toxicity. It should be emphasized the importance of looking for new molecules with reduced toxicity, as well as new targets and mechanisms of action. This work aims to incorporate nonyl 3,4-dihydroxybenzoate, a potent fungicide compound against planktonic cells and dermatophyte biofilms in nanostructured lipid systems (NLS), in order to reduce toxicity in high concentrations, improve its solubility and maintain its effectiveness. The compound was incorporated into NLS constituted by cholesterol, mixture of polyoxyethylene (23) lauryl ether (Brij®98) and soybean phosphatidylcholine (Epikuron® 200)], 2: 1 ratio and PBS (phosphate-buffered saline). The characterization of the incorporation was performed. Susceptibility tests were conducted according to document M38-A2 by CLSI (2008). The toxicity of the NLS compound was evaluated in HaCaT cell lines by the sulforhodamine B method and in alternative models Caenorhabditis elegans and zebrafish. Finally, its efficacy was evaluated against the mature Trichophyton rubrum and Trichophyton mentagrophytes biofilms. NLS and nonyl 3,4-dihydroxybenzoate loaded into NLS displayed sizes ranging from 137.8 ± 1.815 to 167.9 ± 4.070 nm; the polydispersity index (PDI) varying from 0.331 ± 0.020 to 0.377 ± 0.004 and zeta potential ranging from −1.46 ± 0.157 to −4.63 ± 0.398 mV, respectively. Polarized light microscopy results confirmed the formation of NLS of the microemulsion type. Nonyl incorporated into NLS showed minimum inhibitory concentration (MIC) values, ranging from 2 to 15.6 mg/L. The toxicity tests presented cell viability higher than 80% in all tested concentrations, as well as, a significantly increased of the survival of Caenorhabditis elegans and zebrafish models. Anti-biofilm tests proved the efficacy of the incorporation. These findings contribute significantly to the search for new antifungals and allow the systemic administration of the compound, since the incorporation can increase the solubility of non-polar compounds, improve bioavailability, effectiveness and reduce toxicity.
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Affiliation(s)
- Caroline Barcelos Costa-Orlandi
- School of Pharmaceutical Sciences, Department of Clinical Analysis, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Aline Serafim-Pinto
- School of Pharmaceutical Sciences, Department of Clinical Analysis, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Patrícia Bento da Silva
- School of Pharmaceutical Sciences, Department of Drugs and Medicines, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Níura Madalena Bila
- School of Pharmaceutical Sciences, Department of Clinical Analysis, Universidade Estadual Paulista (UNESP), Araraquara, Brazil.,Universidade Eduardo Mondlane, School of Veterinary, Maputo, Mozambique
| | - Jean Lucas de Carvalho Bonatti
- School of Pharmaceutical Sciences, Department of Clinical Analysis, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Liliana Scorzoni
- School of Pharmaceutical Sciences, Department of Clinical Analysis, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Junya de Lacorte Singulani
- School of Pharmaceutical Sciences, Department of Clinical Analysis, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Claudia Tavares Dos Santos
- School of Pharmaceutical Sciences, Department of Clinical Analysis, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Ana Carolina Nazaré
- Institute of Biosciences, Humanities and Exact Sciences, Department of Chemistry and Environmental Sciences, Universidade Estadual Paulista (UNESP), São José do Rio Preto, Brazil
| | - Marlus Chorilli
- School of Pharmaceutical Sciences, Department of Drugs and Medicines, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Luis Octávio Regasini
- Institute of Biosciences, Humanities and Exact Sciences, Department of Chemistry and Environmental Sciences, Universidade Estadual Paulista (UNESP), São José do Rio Preto, Brazil
| | - Ana Marisa Fusco-Almeida
- School of Pharmaceutical Sciences, Department of Clinical Analysis, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
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44
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Aggarwal R, Targhotra M, Sahoo P, Chauhan MK. Onychomycosis: Novel strategies for treatment. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.101774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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45
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Hon KL, Leung AKC. A boy with multiple patches of alopecia and an affected cat. Paediatr Child Health 2020; 26:135-136. [PMID: 33936328 DOI: 10.1093/pch/pxaa035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 03/12/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Kam Lun Hon
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.,Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong
| | - Alexander K C Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta
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46
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Gomes CRB, de Souza MVN, Facchinetti V. A Review on Onychine and its Analogs: Synthesis and Biological Activity. Curr Org Synth 2020; 17:3-22. [PMID: 32103713 DOI: 10.2174/1570179417666191218112842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/07/2019] [Accepted: 12/18/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Onychine is a 4-azafluorenone alkaloid isolated from the Annonaceae family, in low concentrations. Onychine and its analogs exhibit a wide range of pharmacological activities such as antifungal, antibacterial, anticancer, and antimalarial. Because of the high bioactivity of some 4-azafluorenone derivatives, several synthetic methods have been developed for their procurement. OBJECTIVE Considering the importance of these alkaloids, we aim to present the main synthetic approaches to onychines and its derivatives and the biological activity of some 4-azafluorenones. METHODS The most prominent methodologies for the synthesis of onychines were reviewed. RESULTS In this work, we cover many synthetic approaches for the synthesis of onychine and 4-azafluorenone derivatives including intramolecular cyclizations, multicomponent reactions, microwave-assisted multicomponent reactions, Diels-alder reactions, among others. Moreover, we also review the biological activity of 4-azafluorenones. CONCLUSION 4-azafluorenones have risen as prominent structures in medicinal chemistry; however, most of the time, access to new derivatives involves toxic catalysts, harsh reaction conditions, and long-step procedures. Therefore, the development of new synthetic routes with more operational simplicity, simple purification procedure, good yields, and low environmental impact, is desirable.
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Affiliation(s)
- Claudia R B Gomes
- Fundacao Oswaldo Cruz, Instituto de Tecnologia em Farmacos - Farmanguinhos. Rua Sizenando Nabuco 100, Manguinhos, 21041- 250, RJ, Brazil
| | - Marcus V N de Souza
- Fundacao Oswaldo Cruz, Instituto de Tecnologia em Farmacos - Farmanguinhos. Rua Sizenando Nabuco 100, Manguinhos, 21041- 250, RJ, Brazil
| | - Victor Facchinetti
- Fundacao Oswaldo Cruz, Instituto de Tecnologia em Farmacos - Farmanguinhos. Rua Sizenando Nabuco 100, Manguinhos, 21041- 250, RJ, Brazil
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47
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Dennis EK, Garneau-Tsodikova S. Synergistic combinations of azoles and antihistamines against Candida species in vitro. Med Mycol 2020; 57:874-884. [PMID: 30295881 DOI: 10.1093/mmy/myy088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/21/2018] [Accepted: 09/21/2018] [Indexed: 02/07/2023] Open
Abstract
Fungal infections are a major cause of skin and mucosal membrane disease. Immunocompromised individuals, such as those undergoing chemotherapy, are most susceptible to fungal infections. With a growing population of immunocompromised patients, there are many reports of increasing numbers of infections and of fungal strains resistant to current antifungals. One way to treat drug-resistant infections is to administer combinations of drugs to patients. Azoles are the most prescribed antifungals, as they are broad-spectrum and orally bioavailable. Terfenadine (TERF) and ebastine (EBA) are second-generation antihistamines, with EBA being used in many countries. In this study, we explored combinations of seven azole antifungals and two antihistamines (TERF and EBA) against a panel of 13 Candida fungal strains. We found 55 out of 91 combinations tested of TERF and EBA against the various fungal strains to be synergistic with the azoles. To evaluate the efficiency of these combinations to inhibit fungal growth, we performed time-kill assays. We also investigated the ability of these combinations to disrupt biofilm formation. Finally, we tested the specificity of the combinations towards fungal cells by mammalian cytotoxicity assays. These findings suggest a potential new strategy for targeting drug-resistant Candida infections.
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Affiliation(s)
- Emily K Dennis
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 South Limestone Street, Lexington, Kentucky, USA
| | - Sylvie Garneau-Tsodikova
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 South Limestone Street, Lexington, Kentucky, USA
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48
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Obayes AL-Khikani F. Challenges in fungal treatment: A serious public health problem. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2020. [DOI: 10.4103/injms.injms_32_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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49
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Indole-derived chalcones as anti-dermatophyte agents: In vitro evaluation and in silico study. Comput Biol Chem 2019; 84:107189. [PMID: 31891900 DOI: 10.1016/j.compbiolchem.2019.107189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 11/26/2019] [Accepted: 12/08/2019] [Indexed: 01/14/2023]
Abstract
A series of indole-derived methoxylated chalcones were described as anti-dermatophyte agents. The in vitro antifungal susceptibility testing against different dermatophytes revealed that most of compounds had potent activity against the dermatophyte strains. In particular, the 4-ethoxy derivative 4d with MIC values of 0.25-2 μg/ml was the most potent compound against Trichophyton interdigitale, Trichophyton veruccosum and Microsporum fulvum. Moreover, the 4-butoxy analog 4i displaying MIC values in the range of 1-16 μg/ml had the highest inhibitory activity against Trichophyton mentagrophytes, Microsporum canis, and Arthroderma benhamiae. To predict whether the synthesized compounds interact with tubulin binding site of dermatophytes, the 3D-structure of target protein was modeled by homology modeling and then used for molecular docking and molecular dynamics (MD) simulation studies. Docking simulation revealed that the promising compound 4d can properly bind with tubulin. The molecular dynamics analysis showed that interactions of compound 4d with the active site of target protein have binding stability throughout MD simulation. The results of this study could utilize in the design of more effective antifungal drugs with tubulin inhibition mechanism against keratinophilic fungi.
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50
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Alves-Silva JM, Zuzarte M, Gonçalves MJ, Cruz MT, Cavaleiro C, Salgueiro L. Unveiling the bioactive potential of the essential oil of a Portuguese endemism, Santolina impressa. JOURNAL OF ETHNOPHARMACOLOGY 2019; 244:112120. [PMID: 31352022 DOI: 10.1016/j.jep.2019.112120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/26/2019] [Accepted: 07/24/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Santolina species are widely used in traditional medicine in the Mediterranean region for their anti-inflammatory, antimicrobial, antispasmodic, digestive, and analgesic properties. S. impressa, a Portuguese endemism, is traditionally recognized for its beneficial anti-inflammatory properties in several gastrointestinal affections and is also used in oropharyngeal infections. AIM OF THE STUDY The present study aims to characterize the essential oil of S. impressa growing in Portugal and validate its traditional uses by assessing the anti-inflammatory potential of its essential oil at concentrations without toxicity. The antifungal properties of the oil are also addressed, as well as, the putative mechanism of action underlying these effects. MATERIAL AND METHODS The essential oil was obtained in accordance with the European Pharmacopoeia and characterized by GC and GC-MS. The anti-inflammatory potential of the oil was assessed on LPS-stimulated macrophages, through the production of nitric oxide (NO) using the Griess reaction. Putative mechanisms of action included the role of the oil as a NO scavenger, as well as its effect on the expression of two key pro-inflammatory enzymes, iNOS and COX-2 by Western blot analysis. The antifungal effect of the oil was evaluated according to the CLSI guidelines on several yeast and filamentous strains and on two major virulence factors in Candida albicans, namely germ tubes and biofilms. Ultrastructural modifications on dermatophytes were also unveiled by transmission electron microscopy. RESULTS S. impressa essential oil was primarily characterized by the presence of monoterpene hydrocarbons and oxygenated monoterpenes, being the main compounds β-pinene (22.5%), 1,8-cineole (10.0%), limonene (9.1%), camphor (8.1%) and β-phellandrene (8.0%). A significant decrease (ca 60.0%) in nitrite levels was observed in LPS-stimulated macrophages treated with the oil without affecting cell viability. This effect could be explained by a great reduction on iNOS expression (85.0% inhibition), thus underpinning the anti-inflammatory potential of the oil. The oil also showed a fungicidal effect, being more active against Cryptococcus neoformans, Epidermophyton floccosum and Trichophytum rubrum. For these dermatophytes, significant ultrastructural modifications in cell wall structure were detected. Strikingly, for C. albicans, the oil showed a significant anti-infective potential (at 0.07 mg/mL for germ tube inhibition and 0.02 mg/mL for biofilm disruption) before fungal growth inhibition occurred. CONCLUSIONS Our results validate the main traditional use ascribed to S. impressa, namely its anti-inflammatory effect. In addition, an antifungal potential is pointed out, thus corroborating the antimicrobial uses and adding new value to an endemic species poorly recognized by the industry.
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Affiliation(s)
- J M Alves-Silva
- CNC.IBILI, Faculty of Medicine, University of Coimbra, Health Sciences Campus, Azinhaga de S. Comba, 3000-548, Coimbra, Portugal; CIEPQPF and Faculty of Pharmacy, University of Coimbra, Health Sciences Campus, Azinhaga de S. Comba, 3000-548, Coimbra, Portugal.
| | - M Zuzarte
- CNC.IBILI, Faculty of Medicine, University of Coimbra, Health Sciences Campus, Azinhaga de S. Comba, 3000-548, Coimbra, Portugal.
| | - M J Gonçalves
- CIEPQPF and Faculty of Pharmacy, University of Coimbra, Health Sciences Campus, Azinhaga de S. Comba, 3000-548, Coimbra, Portugal.
| | - M T Cruz
- CNC.IBILI, Faculty of Pharmacy, University of Coimbra, Health Sciences Campus, Azinhaga de S. Comba, 3000-548, Coimbra, Portugal.
| | - C Cavaleiro
- CIEPQPF and Faculty of Pharmacy, University of Coimbra, Health Sciences Campus, Azinhaga de S. Comba, 3000-548, Coimbra, Portugal.
| | - L Salgueiro
- CIEPQPF and Faculty of Pharmacy, University of Coimbra, Health Sciences Campus, Azinhaga de S. Comba, 3000-548, Coimbra, Portugal.
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