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Nakamura A, Hirakawa S, Nagai H, Inagaki K. A comparative study between two antifungal agents, Luliconazole and Efinaconazole, of their preventive effects in a Trichophyton-infected guinea pig onychomycosis model. Med Mycol 2021; 59:289-295. [PMID: 33539539 PMCID: PMC7939111 DOI: 10.1093/mmy/myaa111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 12/26/2022] Open
Abstract
An efficacious period of two topical antifungal drugs was compared in a Trichophyton mentagrophytes-infected onychomycosis model in guinea pigs treated with antifungal drugs prior to infection. Luliconazole 5% (LLCZ) and efinaconazole 10% (EFCZ) test solutions were applied to the animals’ nails once daily for 2 weeks followed by a nontreatment period of 2, 4, and 8 weeks. After each nontreatment period, the nails were artificially infected by the fungus. Drug efficacy was quantitatively evaluated by qPCR and histopathological examination of the nails collected following a 4-week post-infection period. The fungal infection was confirmed in the untreated group. Both LLCZ and EFCZ prevented fungal infection in the treated groups with the nontreatment period of 2 weeks. After the nontreatment period of 4 weeks, no infection was observed in the LLCZ-treated group; however, infection into the nail surface and fungal invasion into the nail bed were observed in the EFCZ-treated group. After the nontreatment period of 8 weeks, fungi were found in the nail surface and nail bed in some nails treated with EFCZ; however, no infection was observed in the nail bed of the LLCZ-treated group. The results suggest that LLCZ possesses longer-lasting antifungal effect in nails of the guinea pigs than EFCZ, and that this animal model could be useful for translational research between preclinical and clinical studies to evaluate the pharmacological efficacy of antifungal drugs to treat onychomycosis. This experimentally shown longer-lasting preventive effects of LLCZ could also decrease the likelihoods of onychomycosis recurrence clinically.
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Affiliation(s)
- Akihiro Nakamura
- Research Center, Nihon Nohyaku Co., Ltd., Kawachi-Nagano, Osaka, Japan
| | - Satoko Hirakawa
- Research Center, Nihon Nohyaku Co., Ltd., Kawachi-Nagano, Osaka, Japan
| | - Hiroaki Nagai
- Research Center, Nihon Nohyaku Co., Ltd., Kawachi-Nagano, Osaka, Japan
| | - Katsuhiro Inagaki
- Research Center, Nihon Nohyaku Co., Ltd., Kawachi-Nagano, Osaka, Japan
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Koga H, Munechika Y, Matsumoto H, Nanjoh Y, Harada K, Makimura K, Tsuboi R. Guinea pig seborrheic dermatitis model of Malassezia restricta and the utility of luliconazole. Med Mycol 2021; 58:820-826. [PMID: 31873751 DOI: 10.1093/mmy/myz128] [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: 09/21/2019] [Revised: 11/11/2019] [Accepted: 12/10/2019] [Indexed: 02/03/2023] Open
Abstract
Seborrheic dermatitis (SD) is a multifactorial disease in which Malassezia restricta has been proposed as the predominant pathogenic factor. However, experimental evidence supporting this hypothesis is limited. A guinea pig SD model using a clinical isolate of M. restricta was used to elucidate the pathogenicity of M. restricta. Also, the efficacy of 1% luliconazole (LLCZ) cream, a topical imidazole derivative, against M. restricta was compared with that of a 2% ketoconazole (KCZ) cream in the same guinea pig model. Dorsal skin hairs of guinea pig were clipped and treated with M. restricta by single or repeated inoculations without occlusion. Skin manifestations were examined macroscopically and histologically. A quantitative polymerase chain reaction (PCR) assay was also performed for mycological evaluation. An inflammatory response mimicking SD occurred after repeated as well as single inoculation but not in abraded skin. The inflammation score attained its maximum on day 11 and persisted until day 52. The yeast form of the fungal elements was distributed on the surface of stratum corneum and around the follicular orifices, and an epidermal and dermal histological reaction was observed. Application of 1% LLCZ or 2% KCZ cream significantly improved the skin manifestations and decreased the quantity of M. restricta rDNA in the skin lesions. The efficacy of topical antifungal drugs suggested that M. restricta is a pathogenic factor contributing to SD.
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Affiliation(s)
- Hiroyasu Koga
- Research Center, Nihon Nohyaku Co., Ltd., 345 Oyamada-cho, Kawachi-Nagano, Osaka 586-0094, Japan
| | - Yukimi Munechika
- Research Center, Nihon Nohyaku Co., Ltd., 345 Oyamada-cho, Kawachi-Nagano, Osaka 586-0094, Japan
| | - Hiroko Matsumoto
- Research Center, Nihon Nohyaku Co., Ltd., 345 Oyamada-cho, Kawachi-Nagano, Osaka 586-0094, Japan
| | - Yasuko Nanjoh
- Department of Dermatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Kazutoshi Harada
- Department of Dermatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Koichi Makimura
- Medical Mycology, Graduate School of Medicine, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
| | - Ryoji Tsuboi
- Department of Dermatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
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Iwanaga T, Ushigami T, Anzawa K, Mochizuki T. Viability of pathogenic dermatophytes during a 4-week treatment with 1% topical luliconazole for tinea pedis. Med Mycol 2020; 58:401-403. [PMID: 31111903 PMCID: PMC7108760 DOI: 10.1093/mmy/myz056] [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: 03/12/2019] [Revised: 04/04/2019] [Accepted: 05/03/2019] [Indexed: 12/04/2022] Open
Abstract
The viability of pathogenic fungi in the scale was investigated during topical administration of 1% luliconazole (LLCZ). Thirteen tinea pedis patients found to be positive on KOH examination were assessed by mycological examinations and quantitative real-time polymerase chain reaction (PCR) targeted internal transcribed spacer (ITS) in ribosomal RNA gene at the initial visit and after 2 and 4 weeks of treatment. Assays showed that the average copy number of ITS DNA had significantly decreased to 22.9% at 2 weeks and 4.8% at 4 weeks compared with the initial visit. LLCZ topical treatment could defeat almost pathogenic dermatophytes in the scales within 4 weeks.
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Affiliation(s)
- Tomoyuki Iwanaga
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
| | - Tsuyoshi Ushigami
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
| | - Kazushi Anzawa
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
| | - Takashi Mochizuki
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
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Iwanaga T, Anzawa K, Mochizuki T. Variations in ribosomal DNA copy numbers in a genome of
Trichophyton interdigitale. Mycoses 2020; 63:1133-1140. [PMID: 32783279 PMCID: PMC7607385 DOI: 10.1111/myc.13163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 11/26/2022]
Abstract
Background Ribosomal DNA (rDNA) reportedly has multiple copies in the fungal genome. The internal transcribed spacer (ITS) region in rDNA is useful for investigating relationships between close taxonomic relatives. Thus, ITS has been widely used as a target gene in medical mycology for the detection of pathogenic fungi and identification of fungal species. However, the rDNA copy number in a genome of Trichophyton interdigitale, the pathogen causing dermatophytosis, currently remains unknown. Objective Clarification of the rDNA copy number in a genome of T. interdigitale. Methods rDNA copy numbers in 64 clinical isolates of T. interdigitale were examined using quantitative real‐time PCR (qPCR) with the absolute quantitative method targeting TruMDR2, a single‐copy control gene and the ITS region in rDNA. Results The copy numbers of the rDNA subunit varied among the 64 strains tested, from 24 to 116 copies per genome. The average rDNA copy number ± standard deviation was 59 ± 16. No correlations were observed between the rDNA copy number and colony colour, colony morphology or molecular type of the non‐transcribed spacer region in rDNA. Experiments on rDNA copy numbers obtained from independent colonies of each strain in single‐spore cultures revealed that the copy number was homogeneous within each strain. Conclusion This is the first study to estimate copy numbers of the rDNA subunit in a genome of T. interdigitale. The rDNA copy number of T. interdigitale varied among the strains tested and was homogeneous within each strain.
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Affiliation(s)
- Tomoyuki Iwanaga
- Department of Dermatology Kanazawa Medical University Ishikawa Japan
| | - Kazushi Anzawa
- Department of Dermatology Kanazawa Medical University Ishikawa Japan
| | - Takashi Mochizuki
- Department of Dermatology Kanazawa Medical University Ishikawa Japan
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Jacobson LS, McIntyre L, Mykusz J. Comparison of real-time PCR with fungal culture for the diagnosis of Microsporum canis dermatophytosis in shelter cats: a field study. J Feline Med Surg 2018; 20:103-107. [PMID: 29172910 PMCID: PMC11129271 DOI: 10.1177/1098612x17695899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives Fungal culture requires at least 14 days for a final result, compared with 1-3 days for PCR. The study compared a commercial real-time dermatophyte PCR panel with fungal culture in cats in a shelter setting for: (1) diagnosis of Microsporum canis infection; and (2) determination of mycological cure. Methods This was a cross-sectional, observational study of cats with suspicious skin lesions or suspected exposure to dermatophytosis. Hair samples were collected for fungal culture and PCR prior to treatment and at weekly intervals until two negative culture results were obtained. Results One hundred and thirty-two cats were included, of which 28 (21.2%) were culture positive and 104 (78.8%) culture-negative for M canis. PCR correctly identified all culture-positive cats and 92/104 culture negative cats; there were 12 false-positive PCR results. The sensitivity and specificity of PCR were 100% (95% confidence interval [CI] 87.7-100) and 88.5% (95% CI 80.7-93.9), respectively. Data from 17 cats were available for assessment of mycological cure. At the time of the first and second negative fungal cultures, 14/17 (82.4%) and 11/17 (64.7%) tested PCR positive, respectively. Conclusions and relevance PCR showed high sensitivity and specificity for diagnosis of M canis dermatophytosis compared with fungal culture, but was unreliable for identifying mycological cure. False-positive results were relatively common. There were no false-negative PCR results and a negative PCR test was a reliable finding in this study. The ability to rapidly diagnose or rule out dermatophytosis could be a valuable tool to increase life-saving capacity in animal shelters.
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Motamedi M, Mirhendi H, Zomorodian K, Khodadadi H, Kharazi M, Ghasemi Z, Shidfar MR, Makimura K. Clinical evaluation of β-tubulin real-time PCR for rapid diagnosis of dermatophytosis, a comparison with mycological methods. Mycoses 2017; 60:692-696. [DOI: 10.1111/myc.12648] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 05/25/2017] [Accepted: 05/29/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Marjan Motamedi
- Department of Medical Parasitology and Mycology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
- Department of Medical Parasitology and Mycology; School of Public Health; National Institute of Health Research; Tehran University of Medical Sciences; Tehran Iran
| | - Hossein Mirhendi
- Department of Medical Parasitology and Mycology; School of Medicine; Isfahan University of Medical Sciences; Isfahan Iran
| | - Kamiar Zomorodian
- Department of Medical Parasitology and Mycology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Hossein Khodadadi
- Department of Medical Parasitology and Mycology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Mahboobeh Kharazi
- Department of Medical Parasitology and Mycology; International Campus; Tehran University of Medical Sciences; Tehran Iran
| | - Zeinab Ghasemi
- Department of Medical Parasitology and Mycology; School of Public Health; National Institute of Health Research; Tehran University of Medical Sciences; Tehran Iran
| | - Mohammad Reza Shidfar
- Department of Medical Parasitology and Mycology; School of Public Health; National Institute of Health Research; Tehran University of Medical Sciences; Tehran Iran
| | - Koichi Makimura
- Laboratory of Space and Environmental Medicine; Graduate School of Medicine; Teikyo University; Tokyo Japan
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Pathogenic Dermatophytes Survive in Nail Lesions During Oral Terbinafine Treatment for Tinea Unguium. Mycopathologia 2017; 182:673-679. [PMID: 28281037 PMCID: PMC5500682 DOI: 10.1007/s11046-017-0118-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 01/23/2017] [Indexed: 11/27/2022]
Abstract
Tinea unguium caused by dermatophyte species are usually treated with oral antimycotic, terbinafine (TBF). To understand the mechanisms of improvement and recalcitrance of tinea unguium by oral TBF treatment, a method of quantifying dermatophyte viability in the nail was developed, and the viability of dermatophytes was analyzed in toenail lesions of 14 patients with KOH-positive tinea unguium treated with oral TBF 125 mg/day for up to 16 weeks. Mycological tests, including KOH examination and fungal culture, and targeted quantitative real-time PCR for internal transcribed spacer (ITS) region, including rRNA, were demonstrated at the initial visit and after 8 and 16 weeks of treatment. Assays in eight patients showed that average ITS DNA amount significantly decreased, to 44% at 8 weeks and 36% at 16 weeks compared with 100% at initial visit. No significant difference was observed between at 8 and 16 weeks, despite the TBF concentration in the nail supposedly more than 10-fold higher than the minimum fungicidal concentration for dermatophytes. This finding suggests the pathogenic dermatophytes in nail lesions could survive in a dormant form, such as arthroconidia, during oral TBF treatment. Both antimycotic activity and nail growth are important factors in treatment of tinea unguium.
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Mirhendi H, Motamedi M, Makimura K, Satoh K. Development a diagnostic pan-dermatophyte TaqMan probe real-time PCR assay based on beta tubulin gene. Mycoses 2016; 59:520-7. [PMID: 27071371 DOI: 10.1111/myc.12502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 01/30/2016] [Accepted: 03/05/2016] [Indexed: 11/28/2022]
Abstract
Early differentiation of dermatophytosis from other cutaneous mycoses is essential to avoid inaccurate therapy. DNA-based techniques including real-time PCR have increasingly been considered for detection of fungal elements in clinical specimens. In this study, after partial sequence analysis of beta tubulin (BT2) gene in 13 common and rare pathogenic dermatophyte species, a pan-dermatophyte primer and probe set was designed in a TaqMan probe-based PCR format. The sensitivity and specificity of the system was tested with 22 reference strains of dermatophytes, 234 positive clinical specimens, 32 DNA samples extracted from normal nails, several fungi other than dermatophytes and human DNAs. Analytical detection limit of the designed PCR on serially diluted DNAs of prepared recombinant plasmid indicated that only five molecules per sample are the minimum number for reliable detection by the assay. A total of 226 out of 234 (96.5%) DNAs extracted from clinical samples, but none of the 32 nail samples, from healthy volunteers were positive in PCR. The real-time PCR targeted beta tubulin gene established in this study could be a sensitive diagnostic tool which is significantly faster than the conventional culture method and should be useful in the clinical settings, in large-scale epidemiological studies and in clinical trials of antifungal therapy.
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Affiliation(s)
- Hossein Mirhendi
- Departments of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Departments of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Motamedi
- Departments of Medical Parasitology & Mycology, School of Public Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Koichi Makimura
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Kazuo Satoh
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
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