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Desoubeaux G, Cray C. Rodent Models of Invasive Aspergillosis due to Aspergillus fumigatus: Still a Long Path toward Standardization. Front Microbiol 2017; 8:841. [PMID: 28559881 PMCID: PMC5432554 DOI: 10.3389/fmicb.2017.00841] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 04/24/2017] [Indexed: 01/09/2023] Open
Abstract
Invasive aspergillosis has been studied in laboratory by the means of plethora of distinct animal models. They were developed to address pathophysiology, therapy, diagnosis, or miscellaneous other concerns associated. However, there are great discrepancies regarding all the experimental variables of animal models, and a thorough focus on them is needed. This systematic review completed a comprehensive bibliographic analysis specifically-based on the technical features of rodent models infected with Aspergillus fumigatus. Out the 800 articles reviewed, it was shown that mice remained the preferred model (85.8% of the referenced reports), above rats (10.8%), and guinea pigs (3.8%). Three quarters of the models involved immunocompromised status, mainly by steroids (44.4%) and/or alkylating drugs (42.9%), but only 27.7% were reported to receive antibiotic prophylaxis to prevent from bacterial infection. Injection of spores (30.0%) and inhalation/deposition into respiratory airways (66.9%) were the most used routes for experimental inoculation. Overall, more than 230 distinct A. fumigatus strains were used in models. Of all the published studies, 18.4% did not mention usage of any diagnostic tool, like histopathology or mycological culture, to control correct implementation of the disease and to measure outcome. In light of these findings, a consensus discussion should be engaged to establish a minimum standardization, although this may not be consistently suitable for addressing all the specific aspects of invasive aspergillosis.
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Affiliation(s)
- Guillaume Desoubeaux
- Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of MiamiMiami, FL, USA.,Service de Parasitologie-Mycologie-Médecine tropicale, Centre Hospitalier Universitaire de ToursTours, France.,Centre d'Etude des Pathologies Respiratoires (CEPR) Institut National de la Santé et de la Recherche Médicale U1100/Équipe 3, Université François-RabelaisTours, France
| | - Carolyn Cray
- Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of MiamiMiami, FL, USA
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Thomson P, Mayayo E, López-Fernández L, Guarro J, Capilla J. Combined antifungal therapy against systemic murine infections by rare Cryptococcus species. Mycoses 2016; 60:112-117. [PMID: 27696562 DOI: 10.1111/myc.12569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/29/2016] [Accepted: 08/30/2016] [Indexed: 11/28/2022]
Abstract
Cryptococcus albidus and Cryptococcus laurentii are uncommon species of this genus that in recent decades have increasingly caused opportunistic infections in humans, mainly in immunocompromised patients; the best therapy for such infection being unknown. Using a murine model of systemic infection by these fungi, we have evaluated the efficacy of amphotericin B (AMB) at 0.8 mg/kg, administered intravenously, fluconazole (FLC) or voriconazole (VRC), both administered orally, at 25 mg/kg and the combination of AMB plus VRC against three C. albidus and two C. laurentii strains. All the treatments significantly reduced the fungal burden in all the organs studied. The combination showed a synergistic effect in the reduction in fungal load, working better than both monotherapies. The histopathological study confirmed the efficacy of the treatments.
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Affiliation(s)
- Pamela Thomson
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, IISPV; Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Emilio Mayayo
- Unitat d'Anatomia Patològica, Facultat de Medicina i Ciències de la Salut, IISPV; Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Loida López-Fernández
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, IISPV; Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Josep Guarro
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, IISPV; Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Javier Capilla
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, IISPV; Universitat Rovira i Virgili, Reus, Tarragona, Spain
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In Vivo Synergy of Amphotericin B plus Posaconazole in Murine Aspergillosis. Antimicrob Agents Chemother 2015; 60:296-300. [PMID: 26503653 DOI: 10.1128/aac.01462-15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 10/18/2015] [Indexed: 11/20/2022] Open
Abstract
Aspergillus fumigatus is the main mold causing invasive fungal infection that shows high mortality rates. Therapeutic failure and the increase in drug resistance make it necessary to explore alternative treatments for this infection. We have evaluated the efficacy of amphotericin B at 0.8 mg/kg or 0.3 mg/kg of body weight combined with 40 mg/kg of posaconazole against three A. fumigatus isolates in a murine model of disseminated infection. The combination of the polyene and the azole led to a greater increase in survival and a significantly greater reduction in tissue burden than monotherapies.
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Thi Minh HP, Thanh HN, Tuan QN, Tran Le A, Thanh TB. Development and Evaluation of Antifungal in vivo of Liposomal Amphotericin B. ACTA ACUST UNITED AC 2015. [DOI: 10.3923/ijbc.2015.283.294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Paulussen C, Boulet G, Bosschaerts T, Cos P, Fortin A, Maes L. Efficacy of oleylphosphocholine (OlPC)in vitroand in a mouse model of invasive aspergillosis. Mycoses 2015; 58:127-32. [DOI: 10.1111/myc.12286] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 11/21/2014] [Accepted: 12/05/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Caroline Paulussen
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH); Faculty of Pharmaceutical, Biomedical and Veterinary Sciences; University of Antwerp; Antwerp Belgium
| | - Gaëlle Boulet
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH); Faculty of Pharmaceutical, Biomedical and Veterinary Sciences; University of Antwerp; Antwerp Belgium
| | | | - Paul Cos
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH); Faculty of Pharmaceutical, Biomedical and Veterinary Sciences; University of Antwerp; Antwerp Belgium
| | - Anny Fortin
- Dafra Pharma Research & Development; Turnhout Belgium
| | - Louis Maes
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH); Faculty of Pharmaceutical, Biomedical and Veterinary Sciences; University of Antwerp; Antwerp Belgium
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Animal models of invasive aspergillosis for drug discovery. Drug Discov Today 2014; 19:1380-6. [DOI: 10.1016/j.drudis.2014.06.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 04/10/2014] [Accepted: 06/09/2014] [Indexed: 02/03/2023]
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Fernández-Silva F, Capilla J, Mayayo E, Sutton D, Guarro J. Combination therapy in the treatment of experimental invasive fungal infection by Sarocladium (Acremonium) kiliense. Int J Antimicrob Agents 2014; 44:136-9. [DOI: 10.1016/j.ijantimicag.2014.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 02/21/2014] [Accepted: 03/20/2014] [Indexed: 11/30/2022]
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Evaluation of the efficacies of Amphotericin B, Posaconazole, Voriconazole, and Anidulafungin in a murine disseminated infection by the emerging opportunistic Fungus Sarocladium (Acremonium) kiliense. Antimicrob Agents Chemother 2013; 57:6265-9. [PMID: 24100490 DOI: 10.1128/aac.01484-13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We evaluated and compared the efficacies of different antifungal drugs against Sarocladium kiliense (formerly Acremonium kiliense), a clinically relevant opportunistic fungus, in a murine model of systemic infection. Three clinical strains of this fungus were tested, and the therapy administered was as follows: posaconazole at 20 mg/kg of body weight (twice daily), voriconazole at 40 mg/kg, anidulafungin at 10 mg/kg, or amphotericin B at 0.8 mg/kg. The efficacy was evaluated by prolonged animal survival, tissue burden reduction, and (1→3)-β-d-glucan serum levels. In general, the four antifungal drugs showed high MICs and poor in vitro activity. The efficacy of the different treatments was only modest, since survival rates were never higher than 40% and no drug was able to reduce fungal load in all the organs for the three strains tested. Posaconazole, in spite of its high MICs (≥16 μg/ml), showed the highest efficacy. The (1→3)-β-d-glucan serum levels were equally reduced by all drugs evaluated.
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Abstract
Murine intravenous (IV) challenge models have been widely used in medical mycology to study fungal virulence, host responses, and antifungal efficacy. This chapter describes the well-characterised Candida albicans IV challenge model, where fungal cells are administered directly into the mouse bloodstream to initiate a systemic infection. The preparation of tissue samples from infected mice to allow evaluation of disease progression and host responses is also described.
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In vitro and in vivo activities of posaconazole and amphotericin B in a murine invasive infection by Mucor circinelloides: poor efficacy of posaconazole. Antimicrob Agents Chemother 2012; 56:2246-50. [PMID: 22290952 DOI: 10.1128/aac.05956-11] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The in vitro susceptibility of 17 strains of Mucor circinelloides to amphotericin B and posaconazole was ascertained by using broth microdilution and disk diffusion methods and by determining the minimal fungicidal concentration (MFC). We evaluated the efficacy of posaconazole at 40 mg/kg of body weight/day and amphotericin B at 0.8 mg/kg/day in a neutropenic murine model of disseminated infection by M. circinelloides by using 6 different strains tested previously in vitro. In general, most of the posaconazole MICs were within the range of susceptibility or intermediate susceptibility, while the small inhibition zone diameters (IZDs) were indicative of nonsusceptibility for all isolates tested. The MFCs were ≥ 3 dilutions higher than the corresponding MICs. In contrast, amphotericin B showed good activity against all of the strains tested regardless of the method used. The in vivo studies demonstrated that amphotericin B was effective in prolonging survival and reducing the fungal load. Posaconazole showed poor in vivo efficacy with no correlation with the MIC values. The results suggested that posaconazole should be used with caution in the treatment of infections caused by Mucor circinelloides or by strains of Mucor not identified to the species level.
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Guarro J. Lessons from animal studies for the treatment of invasive human infections due to uncommon fungi. J Antimicrob Chemother 2011; 66:1447-66. [PMID: 21493649 DOI: 10.1093/jac/dkr143] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Clinical experience in the management of opportunistic infections, especially those caused by less common fungi, is, due to their rarity, very scarce; therefore, the most effective treatments remain unknown. The ever-increasing numbers of fungal infections due to opportunistic fungi have repeatedly proven the limitations of the antifungal armamentarium. Moreover, some of these fungi, such as Fusarium spp. or Scedosporium spp., are innately resistant to almost all the available antifungal drugs, which makes the development of new and effective therapies a high priority. Since it is difficult to conduct randomized clinical trials in these uncommon mycoses, the use of animal models is a good alternative for evaluating new therapies. This is an extensive review of the numerous studies that have used animal models for this purpose against a significant number of less common fungi. A table describing the different studies performed on the efficacy of the different drugs tested is included for each fungal species. In addition, there is a summary table showing the conclusions that can be derived from the analysis of the studies and listing the drugs that showed the best results. Considering the wide variability in the response to the antifungals that the different strains of a given species can show, the table highlights the drugs that showed positive results using at least two parameters for evaluating efficacy against at least two different strains without showing any negative results. These data can be very useful for guiding the treatment of rare infections when there is very little experience or when controversial results exist, or when treatment fails.
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Affiliation(s)
- Josep Guarro
- Mycology Unit, Medical School, IISPV, Rovira i Virgili University, 43201 Reus, Spain.
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Javier Pastor F, Guarro J. Micafungina en el tratamiento de la infección fúngica en modelos animales. Rev Iberoam Micol 2009; 26:42-8. [DOI: 10.1016/s1130-1406(09)70007-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Accepted: 02/12/2009] [Indexed: 10/20/2022] Open
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Mariné M, Pastor FJ, Guarro J. Combined antifungal therapy in a murine model of disseminated infection byCladophialophora bantiana. Med Mycol 2009; 47:45-9. [DOI: 10.1080/13693780802526840] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Serena C, Rodríguez MM, Mariné M, Pastor FJ, Guarro J. Combined therapies in a murine model of blastoschizomycosis. Antimicrob Agents Chemother 2007; 51:2608-10. [PMID: 17452487 PMCID: PMC1913274 DOI: 10.1128/aac.00173-07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In a murine model of blastoschizomycosis, amphotericin B combined with micafungin, flucytosine or voriconazole did not improve the efficacy of fluconazole. However, such combinations can constitute therapeutic options for those cases where fluconazole fails.
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Affiliation(s)
- Carolina Serena
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain
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Serena C, Mariné M, Marimon R, Pastor FJ, Guarro J. Effect of antifungal treatment in a murine model of blastoschizomycosis. Int J Antimicrob Agents 2007; 29:79-83. [PMID: 17134881 DOI: 10.1016/j.ijantimicag.2006.08.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2006] [Revised: 08/07/2006] [Accepted: 08/07/2006] [Indexed: 11/29/2022]
Abstract
Blastoschizomyces capitatus is an emerging pathogenic fungus that can cause deep invasive diseases in neutropenic patients. We developed a model of disseminated blastoschizomycosis in immunosuppressed mice to evaluate the effectiveness of amphotericin B, flucytosine, fluconazole and voriconazole. High-dose fluconazole was the most effective drug at prolonging the survival of mice and at reducing fungal burden in the kidneys, spleen and liver.
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Affiliation(s)
- Carolina Serena
- Unitat de Microbiologia, Facultat de Medicina i Ciencies de la Salut, Universitat Rovira i Virgili, Carrer Sant Llorenç, 21.43201 Reus, Spain
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Abstract
The diagnosis of invasive aspergillosis remains very difficult, coupled with limited treatment options. Animal models have been utilized to evaluate both the diagnosis and treatment of infection and to assess the pathogenicity and virulence of the organism. However, animal models have not been standardized and have been used in only a limited fashion for genomic evaluation in this disease. Extensive efforts are underway to expand significantly the Aspergillus genomic information. Thus, the standardization of animal models of invasive aspergillosis is critical to create a unified platform to enhance evaluation of newer genomic information and allow assessment of pathogenicity and virulence factors. Proposed models, supported by a recently awarded National Institutes of Health/National Institute of Allergy and Infectious Diseases contract, will be developed in close interaction with the extended Aspergillus community (including academia and industry) to answer key questions in this disease. The goal of this work is to provide the framework to evaluate genomic targets in animal models in order to improve the diagnosis and treatment of invasive aspergillosis that will ultimately result in improved outcomes of patients with this frequently fatal infection.
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Affiliation(s)
- T F Patterson
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA.
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Capilla J, Mayayo E, Serena C, Pastor FJ, Guarro J. A novel murine model of cerebral scedosporiosis: lack of efficacy of amphotericin B. J Antimicrob Chemother 2004; 54:1092-5. [PMID: 15509616 DOI: 10.1093/jac/dkh468] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Cerebral scedosporiosis is a life-threatening infection that is difficult to treat. The aim of this work was to develop a murine model of cerebral infection by Scedosporium apiospermum using intracranial inoculation and to use this model to evaluate the efficacy of amphotericin B deoxycholate and liposomal amphotericin B. METHODS Mice were rendered neutropenic by intraperitoneal cyclophosphamide and intravenous (iv) 5-fluorouracil administration. Animals were infected with iv or intracranial inoculation of 1 x 10(4), 5 x 10(4) or 5 x 10(5) cfu of a clinical strain of S. apiospermum. Tissue burden reduction was determined in kidneys and brain 4 days after the infection. Efficacy of amphotericin B and liposomal amphotericin B (0.8 mg/kg/day intraperitoneally and 40 mg/kg/day iv, respectively) was evaluated in neutropenic mice infected iv or intracranially with 5 x 10(4) cfu. Survival was analysed with the log-rank test. Fungal burden values of different groups were compared using the Mann-Whitney U-test. RESULTS In our model, intracranial infection produced a higher fungal load in the brain and a lower fungal load in the kidney than iv inoculation. Survival of animals infected intracranially and treated with amphotericin B or liposomal amphotericin B (mean survival time = 8.3 and 9.2 days, respectively) was not different from the control group (P=0.58 and 0.85, respectively). CONCLUSIONS We have developed a murine model of cerebral scedosporiosis, which may be useful for studying various pathological aspects of this infection and evaluating new therapeutic approaches. Amphotericin B and liposomal amphotericin B were unable to resolve the infection.
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Affiliation(s)
- Javier Capilla
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
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Najvar LK, Cacciapuoti A, Hernandez S, Halpern J, Bocanegra R, Gurnani M, Menzel F, Loebenberg D, Graybill JR. Activity of posaconazole combined with amphotericin B against Aspergillus flavus infection in mice: comparative studies in two laboratories. Antimicrob Agents Chemother 2004; 48:758-64. [PMID: 14982761 PMCID: PMC353105 DOI: 10.1128/aac.48.3.758-764.2004] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Posaconazole and/or amphotericin B was given to mice pretreated with a steroid and then infected by inhalation of Aspergillus flavus conidia. Two laboratories conducted studies using almost identical protocols to evaluate both survival and lung tissue burdens 8 days after infection. The results of the in vivo studies performed at both laboratories were consistent. We found that (i). up to 5 mg of amphotericin B per kg of body weight was poorly effective in treating invasive aspergillosis; (ii). posaconazole at 2 or 10 mg/kg/dose prolonged survival and reduced lung tissue CFU; and (iii). there was generally no antagonistic interaction of the drugs in combination, even when the experiments were designed to maximize the likelihood of antagonism. These studies do not confirm the antagonistic interaction of triazoles and polyenes reported by others.
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Affiliation(s)
- Laura K Najvar
- Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA.
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