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Chen B, Zhang J, Li J, Qian Y, Huang B, Wu X. Comparative Transcriptome Analysis of T. rubrum, T. mentagrophytes, and M. gypseum Dermatophyte Biofilms in Response to Photodynamic Therapy. Mycopathologia 2024; 189:59. [PMID: 38890181 DOI: 10.1007/s11046-024-00865-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/16/2024] [Indexed: 06/20/2024]
Abstract
Dermatophyte biofilms frequently count for inadequate responses and resistance to standard antifungal treatments, resulting in refractory chronic onychomycosis infection. Although antimicrobial photodynamic therapy (aPDT) has clinically proven to exert significant antifungal effects or even capable of eradicating dermatophyte biofilms, considerably less is known about the molecular mechanisms underlying aPDT and the potential dysregulation of signaling networks that could antagonize its action. The aim of this study is to elucidate the molecular mechanisms underlining aPDT combat against dermatophyte biofilm in recalcitrant onychomycosis and to decipher the potential detoxification processes elicited by aPDT, facilitating the development of more effective photodynamic interventions. We applied genome-wide comparative transcriptome analysis to investigate how aPDT disrupting onychomycosis biofilm formed by three distinct dermatophytes, including Trichophyton rubrum, Trichophyton mentagrophytes, and Microsporum gypseum, the most frequently occurring pathogenic species. In total, 352.13 Gb of clean data were obtained for the transcriptomes of dermatophyte biofilms with or without aPDT treatment, resulting in 2,422.42 million reads with GC content of 51.84%, covering 99.9%, 98.5% and 99.4% of annotated genes of T. rubrum, T. mentagrophytes, and M. gypseum, respectively. The genome-wide orthologous analysis identified 6624 transcribed single-copy orthologous genes in all three species, and 36.5%, 6.8% and 17.9% of which were differentially expressed following aPDT treatment. Integrative orthology analysis demonstrated the upregulation of oxidoreductase activities is a highly conserved detoxification signaling alteration in response to aPDT across all investigated dermatophyte biofilms. This study provided new insights into the molecular mechanisms underneath anti-dermatophyte biofilm effects of aPDT and successfully identified a conserved detoxification regulation upon the aPDT application.
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Affiliation(s)
- Borui Chen
- Dermatology Institute of Fuzhou, Dermatology Hospital of Fuzhou, Xihong Road 243, Fuzhou, 350025, China
- Department of Dermatology, First Hospital and Research Center for Medical Mycology, Peking University, Beijing, 100034, China
| | - Jinyan Zhang
- Department of Dermatology, First Hospital and Research Center for Medical Mycology, Peking University, Beijing, 100034, China
- Department of Dermatology, Fujian Provincial Geriatric Hospital, Fuzhou, 350025, China
| | - Juanjuan Li
- Dermatology Institute of Fuzhou, Dermatology Hospital of Fuzhou, Xihong Road 243, Fuzhou, 350025, China
| | - Yuwen Qian
- Fujun Genetics Technologies Company Limited, Fuzhou, 350003, China
| | - Binbin Huang
- Dermatology Institute of Fuzhou, Dermatology Hospital of Fuzhou, Xihong Road 243, Fuzhou, 350025, China
| | - Xiaomo Wu
- Dermatology Institute of Fuzhou, Dermatology Hospital of Fuzhou, Xihong Road 243, Fuzhou, 350025, China.
- Department of Biomedicine, University of Basel, Klingelbergstrass 70, 4056, Basel, Switzerland.
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Gil-Pallares P, Gracia-Cazaña T, Álvarez-Salafranca M, Gorgojo MA, García-García M, Beltrán-Rosel A, Almenara-Blasco M, Navarro-Bielsa A, Gilaberte Y. Cutaneous Alternariosis in Immunosuppressed Patients Treated with Photodynamic Therapy and Oral Antifungals, a Synergistic Strategy. Pharmaceuticals (Basel) 2024; 17:245. [PMID: 38399460 PMCID: PMC10893038 DOI: 10.3390/ph17020245] [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: 12/18/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Cutaneous alternariosis is a rare condition, more frequently presented in immunocompromised patients, which usually requires long courses of systemic antifungals that may interact with other medications. The presented series shows three cases of cutaneous alternariosis in immunocompromised patients and organ transplant recipients that were successfully treated with photodynamic therapy and oral antifungals, allowing a reduction in the systemic treatment duration and therefore decreasing the risk of side effects and drug interactions.
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Affiliation(s)
- Pedro Gil-Pallares
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Department of Surgery and Medical-Surgical Specialities, Universidad de Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Tamara Gracia-Cazaña
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Marcial Álvarez-Salafranca
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
| | | | - Mar García-García
- Department of Pathology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain;
| | - Antonio Beltrán-Rosel
- Department of Microbiology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain
| | - Manuel Almenara-Blasco
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Alba Navarro-Bielsa
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Yolanda Gilaberte
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Department of Dermatology, University of Zaragoza, 50009 Zaragoza, Spain
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Piksa M, Lian C, Samuel IC, Pawlik KJ, Samuel IDW, Matczyszyn K. The role of the light source in antimicrobial photodynamic therapy. Chem Soc Rev 2023; 52:1697-1722. [PMID: 36779328 DOI: 10.1039/d0cs01051k] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Antimicrobial photodynamic therapy (APDT) is a promising approach to fight the growing problem of antimicrobial resistance that threatens health care, food security and agriculture. APDT uses light to excite a light-activated chemical (photosensitiser), leading to the generation of reactive oxygen species (ROS). Many APDT studies confirm its efficacy in vitro and in vivo against bacteria, fungi, viruses and parasites. However, the development of the field is focused on exploring potential targets and developing new photosensitisers. The role of light, a crucial element for ROS production, has been neglected. What are the main parameters essential for effective photosensitiser activation? Does an optimal light radiant exposure exist? And finally, which light source is best? Many reports have described the promising antibacterial effects of APDT in vitro, however, its application in vivo, especially in clinical settings remains very limited. The restricted availability may partially be due to a lack of standard conditions or protocols, arising from the diversity of selected photosensitising agents (PS), variable testing conditions including light sources used for PS activation and methods of measuring anti-bacterial activity and their effectiveness in treating bacterial infections. We thus sought to systematically review and examine the evidence from existing studies on APDT associated with the light source used. We show how the reduction of pathogens depends on the light source applied, radiant exposure and irradiance of light used, and type of pathogen, and so critically appraise the current state of development of APDT and areas to be addressed in future studies. We anticipate that further standardisation of the experimental conditions will help the field advance, and suggest key optical and biological parameters that should be reported in all APDT studies. More in vivo and clinical studies are needed and are expected to be facilitated by advances in light sources, leading to APDT becoming a sustainable, alternative therapeutic option for bacterial and other microbial infections in the future.
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Affiliation(s)
- Marta Piksa
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Weigla 12, 53-114, Wroclaw, Poland
| | - Cheng Lian
- Organic Semiconductor Centre, SUPA, School of Physics and Astronomy, University of St Andrews, Fife, KY16 9SS, UK.
| | - Imogen C Samuel
- School of Medicine, University of Manchester, Manchester, M13 9PL, UK
| | - Krzysztof J Pawlik
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Weigla 12, 53-114, Wroclaw, Poland
| | - Ifor D W Samuel
- Organic Semiconductor Centre, SUPA, School of Physics and Astronomy, University of St Andrews, Fife, KY16 9SS, UK.
| | - Katarzyna Matczyszyn
- Institute of Advanced Materials, Faculty of Chemistry, Wroclaw University of Science and Technology, Wyb. Wyspianskiego 27, 50-370 Wroclaw, Poland.
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Pereira JAL, de Moraes LS, de Sena CBC, do Nascimento JLM, Rodrigues APD, da Silva SHM, Silva EO. Inhibition of Melanization by Kojic Acid Promotes Cell Wall Disruption of the Human Pathogenic Fungus Fonsecaea sp. Pathogens 2022; 11:pathogens11080925. [PMID: 36015045 PMCID: PMC9414132 DOI: 10.3390/pathogens11080925] [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: 06/21/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
Chromoblastomycosis (CBM) is a chronic human subcutaneous mycosis caused by various aetiologic agents. CBM does not have an established treatment but may be managed using antifungal agents, surgical removal of the lesions, or cryotherapy. Kojic acid (KA), a known tyrosinase inhibitor with a variety of biological actions, including fungistatic action against the fungus Cryptococcus neoformans, mediated by inhibiting melanin production, seems to be an alternative to improve the treatment of CBM. The aim of the present study was to analyze the action of KA against the pathogenic fungus Fonsecaea sp., an aetiological agent of CBM. The fungal culture was incubated with KA, and the amount of melanin was assessed, followed by cytochemical detection. Subsequently, the samples were analyzed by light microscopy, transmission and scanning electron microscopy. Culture analysis revealed that 100 g/mL KA significantly decreased the melanization of the fungus and the exocytosis of melanin into the culture supernatant. Additionally, KA induced less growth of biofilm formation and intense disruption of the cell wall, and decreased the number of melanin-containing vesicles in the culture supernatant. Finally, KA inhibited fungal filamentation in culture and the subsequent phagocytosis process. Thus, KA may be a promising substance to help in the treatment of CBM.
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Affiliation(s)
- Jorge Augusto Leão Pereira
- Laboratory of Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Lienne Silveira de Moraes
- Laboratory of Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
- National Institute of Science and Technology in Structural Biology and Bioimaging, Rio de Janeiro 21040-900, RJ, Brazil
- Pharmaceutical Sciences Post Graduation Program, Health and Biological Sciences Department, Federal University of Amapa (UNIFAP), Macapá 68903-329, AP, Brazil
| | - Chubert Bernardo Castro de Sena
- Laboratory of Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
- National Institute of Science and Technology in Neuroimmunomodulation (INCT—NIM), Rio de Janeiro 21040-900, RJ, Brazil
| | - José Luiz Martins do Nascimento
- Pharmaceutical Sciences Post Graduation Program, Health and Biological Sciences Department, Federal University of Amapa (UNIFAP), Macapá 68903-329, AP, Brazil
- National Institute of Science and Technology in Neuroimmunomodulation (INCT—NIM), Rio de Janeiro 21040-900, RJ, Brazil
- Laboratory of Molecular and Cellular Neurochemistry, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Ana Paula D. Rodrigues
- National Institute of Science and Technology in Structural Biology and Bioimaging, Rio de Janeiro 21040-900, RJ, Brazil
- Laboratory of Electron Microscopy, Evandro Chagas Institute, Ministry of Health, Belém 66093-020, PA, Brazil
| | - Silvia Helena Marques da Silva
- Laboratory of Superficial and Systemic Mycoses, Evandro Chagas Institute, Department of Mycology and Bacteriology, Ministry of Health, Ananindeua 67030-000, PA, Brazil
| | - Edilene O. Silva
- Laboratory of Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
- National Institute of Science and Technology in Structural Biology and Bioimaging, Rio de Janeiro 21040-900, RJ, Brazil
- Correspondence: ; Tel.: +055-9132-0175-46
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Wu X, Hu Y. Photodynamic Therapy for the Treatment of Fungal Infections. Infect Drug Resist 2022; 15:3251-3266. [PMID: 35761978 PMCID: PMC9233483 DOI: 10.2147/idr.s369605] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
Cutaneous fungal infections are common in humans and are associated with significant physical and psychological distress to patients. Although conventional topical and/or oral anti-fungal medications are commonly recommended treatments, drug resistance has emerged as a significant concern in this patient population, and safer, more efficacious, and cost-effective alternatives are warranted. Recent studies have reported effectiveness of photodynamic therapy (PDT) against fungal infections without severe adverse effects. In this review, we briefly discuss the mechanisms underlying PDT, current progress, adverse effects, and limitations of this treatment in the management of superficial and deep fungal infections.
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Affiliation(s)
- Xuelin Wu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
| | - Yongxuan Hu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
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6
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Legabão BC, Fernandes JA, de Oliveira Barbosa GF, Bonfim-Mendonça PS, Svidzinski TI. The zoonosis sporotrichosis can be successfully treated by photodynamic therapy: A scoping review. Acta Trop 2022; 228:106341. [PMID: 35131203 DOI: 10.1016/j.actatropica.2022.106341] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 12/20/2022]
Abstract
Sporotrichosis is a worldwide zoonosis, prevalent in tropical and subtropical regions. In recent years, there has been a substantial increase in human and feline cases reported in Brazil. Despite this, the antifungal treatment for sporotrichosis is still limited, and thus, research into new therapeutic modalities must be encouraged. Recently, photodynamic therapy has been introduced as a treatment for sporotrichosis. This work presents an overview of both in vitro and in vivo studies that have used photodynamic therapy in the context of photoinactivation of Sporothrix species. Until now, as far as the authors are aware, this is the first scope review specifically on photodynamic therapy for the treatment of sporotrichosis. A systematic electronic search was conducted in two databases: Web of Science and PubMed. Seven original articles published from 2010 to July 2021 were selected, six of which met the proposed inclusion and exclusion criteria and were considered in this scoping review. Concerning the photoinactivation of Sporothrix spp. the results have been promising as studies, in both animals and humans, have reported significant clinical and mycological effects. The most used photosensitizers were methylene blue and its derivatives, and aminolevulinic acid and its methyl derivative, methyl aminolevulinic acid. In conclusion, photodynamic therapy has great potential in treatment of sporotrichosis, as its fungicidal effect both in vitro and in vivo has clearly been demonstrated. Photodynamic therapy could be used in conjunction with classic antifungal agents to optimize treatment outcomes.
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Ziental D, Mlynarczyk DT, Czarczynska-Goslinska B, Lewandowski K, Sobotta L. Photosensitizers Mediated Photodynamic Inactivation against Fungi. NANOMATERIALS 2021; 11:nano11112883. [PMID: 34835655 PMCID: PMC8621466 DOI: 10.3390/nano11112883] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 01/12/2023]
Abstract
Superficial and systemic fungal infections are essential problems for the modern health care system. One of the challenges is the growing resistance of fungi to classic antifungals and the constantly increasing cost of therapy. These factors force the scientific world to intensify the search for alternative and more effective methods of treatment. This paper presents an overview of new fungal inactivation methods using Photodynamic Antimicrobial Chemotherapy (PACT). The results of research on compounds from the groups of phenothiazines, xanthanes, porphyrins, chlorins, porphyrazines, and phthalocyanines are presented. An intensive search for a photosensitizer with excellent properties is currently underway. The formulation based on the existing ones is also developed by combining them with nanoparticles and common antifungal therapy. Numerous studies indicate that fungi do not form any specific defense mechanism against PACT, which deems it a promising therapeutic alternative.
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Affiliation(s)
- Daniel Ziental
- Chair and Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland; (D.Z.); (K.L.)
| | - Dariusz T. Mlynarczyk
- Chair and Department of Chemical Technology of Drugs, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland;
| | - Beata Czarczynska-Goslinska
- Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland;
| | - Konrad Lewandowski
- Chair and Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland; (D.Z.); (K.L.)
| | - Lukasz Sobotta
- Chair and Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, Grunwaldzka 6, 60-780 Poznan, Poland; (D.Z.); (K.L.)
- Correspondence:
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Hu Y, Qi X, Sun H, Lu Y, Hu Y, Chen X, Liu K, Yang Y, Mao Z, Wu Z, Zhou X. Photodynamic therapy combined with antifungal drugs against chromoblastomycosis and the effect of ALA-PDT on Fonsecaea in vitro. PLoS Negl Trop Dis 2019; 13:e0007849. [PMID: 31671098 PMCID: PMC6850556 DOI: 10.1371/journal.pntd.0007849] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 11/12/2019] [Accepted: 10/16/2019] [Indexed: 01/06/2023] Open
Abstract
Background Chromoblastomycosis is a chronic skin and subcutaneous fungal infection caused by dematiaceous fungi and is associated with low cure and high relapse rates. In southern China, Fonsecaea monophora and Fonsecaea pedrosoi are the main causative agents. Principal findings We treated 5 refractory and complex cases of chromoblastomycosis with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) combined with oral antifungal drugs. The lesions improved after 4 to 9 sessions of ALA-PDT treatment at an interval of one or two weeks, and in some cases, mycological testing results became negative. The isolates were assayed for susceptibility to antifungal drugs and ALA-PDT in vitro, revealing sensitivity to terbinafine, itraconazole and voriconazole, with ALA-PDT altering the cell wall and increasing reactive oxygen species production. Conclusions These results provide the basis for the development of a new therapeutic approach, and ALA-PDT combined with oral antifungal drugs constitutes a promising alternative method for the treatment of refractory and complex cases of chromoblastomycosis. Chromoblastomycosis, a neglected tropical disease, is one of the most frequently encountered subcutaneous mycoses. The disease is usually caused by traumatic inoculation of a specific group of dematiaceous fungi. Chromoblastomycosisis characterized by slowly expanding skin lesions and is associated with low cure and high relapse rates. In recent years, effective methods, such as photodynamic therapy (PDT), have been employed for inhibiting the pathogen’s activity. The authors treated 5 refractory and complex cases of chromoblastomycosis with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) combined with oral antifungal drugs. The lesions improved after 4 to 9 sessions of ALA-PDT treatment at an interval of one or two weeks, and in some cases, mycological testing results became negative. The authors also found that ALA-PDT alter the fungi cell wall and increase reactive oxygen species production. This research provides the basis for the development of a new therapeutic approach, and ALA-PDT combined with oral antifungal drugs constitutes a promising alternative method for the treatment of refractory and complex cases of chromoblastomycosis.
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Affiliation(s)
- Yongxuan Hu
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
- * E-mail: (YH); (XZ)
| | - Xinyu Qi
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Hengbiao Sun
- Department of Clinical Laboratory, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Yan Lu
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Yanqing Hu
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Xuyang Chen
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Kangxing Liu
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Yemei Yang
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Zuhao Mao
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Zhong Wu
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Xianyi Zhou
- Department of Dermatology and Venerology, The 3rd Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
- * E-mail: (YH); (XZ)
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Tan J, Liu Z, Sun Y, Yang L, Gao L. Inhibitory Effects of Photodynamic Inactivation on Planktonic Cells and Biofilms of Candida auris. Mycopathologia 2019; 184:525-531. [PMID: 31230199 DOI: 10.1007/s11046-019-00352-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 06/13/2019] [Indexed: 11/29/2022]
Abstract
Candida auris is an emerging pathogen that has caused numerous severe infections in recent years, and has therefore become a global concern for public health agencies. Most conventional antifungal agents, especially fluconazole, have shown limited effects on this pathogen. New methods to restrict this pathogen are in urgent demand. Antimicrobial photodynamic therapy (aPDT) has been shown to be a promising technique against multiple pathogenic fungi. This study sought to determine the in vitro effect of aPDT using methylene blue (MB) combined with light-emitting diode (LED) on the viability of planktonic cells and biofilms of five clinical strains of C. auris. MB (8, 16 and 32 μg/ml) was applied as the photosensitizer, and a LED (635 nm, 12 and 24 J/cm2) device was used as light source to activate the photosensitizer. The results showed that there was no growth of tested C. auris strains following aPDT on planktonic cultures. In addition, aPDT exhibited colony-forming unit reduction of up to 7.20 log10 against C. auris biofilms. These data demonstrate that in vitro aPDT with MB and LED offers promising potential for the treatment of C. auris infections.
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Affiliation(s)
- Jingwen Tan
- Department of Medical Mycology, Shanghai Dermatology Hospital, Shanghai, 200443, China
| | - Zhaoyang Liu
- Department of Stomatology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, 434100, China
| | - Yi Sun
- Department of Dermatology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, 434100, China
| | - Lianjuan Yang
- Department of Medical Mycology, Shanghai Dermatology Hospital, Shanghai, 200443, China.
| | - Lujuan Gao
- Department of Dermatology, Zhongshan Hospital Fudan University, Shanghai, 200032, China.
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10
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Chen B, Sun Y, Zhang J, Chen R, Zhong X, Wu X, Zheng L, Zhao J. In vitro Evaluation of Photodynamic Effects Against Biofilms of Dermatophytes Involved in Onychomycosis. Front Microbiol 2019; 10:1228. [PMID: 31231330 PMCID: PMC6568038 DOI: 10.3389/fmicb.2019.01228] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 05/16/2019] [Indexed: 02/01/2023] Open
Abstract
Dermatophytes are the most common cause of onychomycosis, counting for 90% fungal nail infection. Although dermatophyte pathogens are normally susceptible to antifungal agents, onychomycosis often results in refractory chronic disease, and the formation of biofilms frequently underlines the inadequate responses and resistance to standard antifungal treatment. Numerous in vitro and in vivo antimicrobial photodynamic therapy (aPDT) studies have shown biofilm eradication or substantial reduction, however, such investigation has not yet been expanded to the biofilms of dermatophytes involved in onychomycosis. To shed a light on the potential application of aPDT in the clinic management of onychomycosis, in particular with the manifestation of dermatophytoma, we investigated photodynamic effects on the viabilities and the drug susceptibilities of the biofilm of dermatophytes in vitro. Here, methylene blue at the concentration of 8, 16, and 32 μg/ml applied as photosensitizing agent and LED (635 ± 10 nm, 60 J/cm2) as light source were employed against six strains of Trichophyton rubrum, ten strains of Trichophyton mentagrophytes and three strains of Microsporum gypseum isolated from clinical specimens. Our results indicated highly efficient photodynamic inhibition, exhibiting CFU (colony forming unit) reduction up to 4.6 log10, 4.3 log10, and 4.7 log10 against the biofilms formed by T. rubrum, T. mentagrophytes, and M. gypseum, respectively. Subjected biofilms displayed considerable decreases in SMICs (sessile minimum inhibitory concentrations) to multiple antifungal agents when compared with untreated groups, indicating the biofilms of dermatophytes became more susceptible to conventional antifungal drugs after aPDT. Additionally, the obliteration of biofilm after aPDT could be observed as shattered and ruptured structures being evident in SEM (Scanning Electron Microscopy) images. These findings suggest that aPDT is an attractive alternative treatment holding great promise for combating recalcitrant onychomycosis associated with the biofilm formation.
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Affiliation(s)
- Borui Chen
- Department of Dermatology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.,Dermatology Hospital of Fuzhou, Fuzhou, China
| | - Yi Sun
- Department of Dermatology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, China
| | | | - Ruijun Chen
- Dermatology Hospital of Fuzhou, Fuzhou, China
| | - Xiurong Zhong
- Electron Microscopy Laboratory, Fujian Medical University, Fuzhou, China
| | - Xiaomo Wu
- Dermatology Hospital of Fuzhou, Fuzhou, China
| | - Libao Zheng
- Dermatology Hospital of Fuzhou, Fuzhou, China
| | - Jingjun Zhao
- Department of Dermatology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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Chen F, Jiang R, Dong S, Yan B. Efficient Treatment of Sporothrix globosa Infection Using the Antibody Elicited by Recombinant Phage Nanofibers. Front Pharmacol 2019; 10:160. [PMID: 30873031 PMCID: PMC6400886 DOI: 10.3389/fphar.2019.00160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 02/11/2019] [Indexed: 11/20/2022] Open
Abstract
Antifungal therapy is used to treat sporotrichosis. However, there are several limitations in this therapy, such as development of drug resistance and potential health risks including liver injury. The purpose of our study was to evaluate the antifungal efficacy of antibody against the hybrid phage nanofibers displaying KPVQHALLTPLGLDR (phage-KR) in a fungal-infected mouse model. In this study, we extracte an antibody against hybrid phage nanofibers (phage-KR) from immunized mice and passively inoculate Sporothrix globosa (S. globosa) infected mice. The study shows that the antibody exhibits efficient inhibition efficacy of the S. globosa infection, including reduction of the progressive fungi colonizing, increase of animal survival rate and relief of organ inflammation in the mice. The results indicate that antibody against phage-KR may act as a potential strategy for safe and efficient treatment of S. globosa infections.
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Affiliation(s)
- Feng Chen
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Rihua Jiang
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Shuai Dong
- Department of Gynecology and Obstetrics, The First Hospital of Jilin University, Changchun, China
| | - Bailing Yan
- Department of Emergency, The First Hospital of Jilin University, Changchun, China
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12
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Abstract
Chromoblastomycosis (CBM), also known as chromomycosis, is one of the most prevalent implantation fungal infections, being the most common of the gamut of mycoses caused by melanized or brown-pigmented fungi. CBM is mainly a tropical or subtropical disease that may affect individuals with certain risk factors around the world. The following characteristics are associated with this disease: (i) traumatic inoculation by implantation from an environmental source, leading to an initial cutaneous lesion at the inoculation site; (ii) chronic and progressive cutaneous and subcutaneous tissular involvement associated with fibrotic and granulomatous reactions associated with microabscesses and often with tissue proliferation; (iii) a nonprotective T helper type 2 (Th2) immune response with ineffective humoral involvement; and (iv) the presence of muriform (sclerotic) cells embedded in the affected tissue. CBM lesions are clinically polymorphic and are commonly misdiagnosed as various other infectious and noninfectious diseases. In its more severe clinical forms, CBM may cause an incapacity for labor due to fibrotic sequelae and also due to a series of clinical complications, and if not recognized at an early stage, this disease can be refractory to antifungal therapy.
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13
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Lu Q, Sun Y, Tian D, Xiang S, Gao L. Effects of Photodynamic Therapy on the Growth and Antifungal Susceptibility of Scedosporium and Lomentospora spp. Mycopathologia 2017; 182:1037-1043. [PMID: 28836110 DOI: 10.1007/s11046-017-0195-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 08/18/2017] [Indexed: 01/08/2023]
Abstract
Scedosporium and Lomentospora species are the second most frequent colonizing, allergenic, or invasive fungal pathogens in patients with cystic fibrosis, and are responsible for infections varying from cutaneous and subcutaneous tissue infections caused by traumatic inoculation to severe systemic diseases in immunocompromised patients. The clinical relevance of fungal airway colonization for individual patients harboring Scedosporium and Lomentospora species is still an underestimated issue. The high resistance of Scedosporium and Lomentospora species to antifungal drugs has highlighted the need for alternative treatment modalities, and antimicrobial photodynamic therapy may be one such alternative. In this study, methylene blue was applied as a photosensitizing agent to 6 type strains of Scedosporium and Lomentospora species, and we irradiated the strains using a light-emitting diode (635 ± 10 nm, 12 J/cm2). We evaluated the effects of photodynamic therapy on strain growth and on the in vitro susceptibility of the strains to itraconazole, voriconazole, posaconazole, and amphotericin B. A colony-forming unit reduction of up to 5.2 log10 was achieved. Minimal inhibitory concentration ranges also decreased significantly with photoinactivation. Photodynamic therapy improved both the inactivation rates and the antifungal susceptibility profile of all fungal isolates tested.
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Affiliation(s)
- Qiaoyun Lu
- Department of Dermatology, Central Hospital of Xiangyang, Hubei College of Arts and Science, No. 136 Jingzhou Street, Xiangcheng District, Xiangyang, 441021, People's Republic of China.
| | - Yi Sun
- Department of Dermatology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, 434100, People's Republic of China
| | - Dingdan Tian
- Department of Dermatology, Hospital of Wuhan University, Wuhan, 430000, People's Republic of China
| | - Shoubao Xiang
- Department of Dermatology, Central Hospital of Xiangyang, Hubei College of Arts and Science, No. 136 Jingzhou Street, Xiangcheng District, Xiangyang, 441021, People's Republic of China
| | - Lujuan Gao
- Department of Dermatology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, People's Republic of China.
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Gao L, Jiang S, Sun Y, Deng M, Wu Q, Li M, Zeng T. Evaluation of the Effects of Photodynamic Therapy Alone and Combined with Standard Antifungal Therapy on Planktonic Cells and Biofilms of Fusarium spp. and Exophiala spp. Front Microbiol 2016; 7:617. [PMID: 27199946 PMCID: PMC4847004 DOI: 10.3389/fmicb.2016.00617] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 04/14/2016] [Indexed: 12/02/2022] Open
Abstract
Infections of Fusarium spp. and Exophiala spp. are often chronic, recalcitrant, resulting in significant morbidity, causing discomfort, disfigurement, social isolation. Systemic disseminations happen in compromised patients, which are often refractory to available antifungal therapies and thereby lead to death. The antimicrobial photodynamic therapy (aPDT) has been demonstrated to effectively inactivate multiple pathogenic fungi and is considered as a promising alternative treatment for mycoses. In the present study, we applied methylene blue (8, 16, and 32 μg/ml) as a photosensitizing agent and light emitting diode (635 ± 10 nm, 12 and 24 J/cm2), and evaluated the effects of photodynamic inactivation on five strains of Fusarium spp. and five strains of Exophiala spp., as well as photodynamic effects on in vitro susceptibility to itraconazole, voriconazole, posaconazole and amphotericin B, both planktonic and biofilm forms. Photodynamic therapy was efficient in reducing the growth of all strains tested, exhibiting colony forming unit-reductions of up to 6.4 log10 and 5.6 log10 against planktonic cultures and biofilms, respectively. However, biofilms were less sensitive since the irradiation time was twice longer than that of planktonic cultures. Notably, the photodynamic effects against Fusarium strains with high minimal inhibitory concentration (MIC) values of ≥16, 4-8, 4-8, and 2-4 μg/ml for itraconazole, voriconazole, posaconazole and amphotericin B, respectively, were comparable or even superior to Exophiala spp., despite Exophiala spp. showed relatively better antifungal susceptibility profile. MIC ranges against planktonic cells of both species were up to 64 times lower after aPDT treatment. Biofilms of both species showed high sessile MIC50 (SMIC50) and SMIC80 of ≥16 μg/ml for all azoles tested and variable susceptibilities to amphotericin B, with SMIC ranging between 1 and 16 μg/ml. Biofilms subjected to aPDT exhibited a distinct reduction in SMIC50 and SMIC80 compared to untreated groups for both species, except SMIC80 of itraconazole against Fusarium biofilms. In conclusion, in vitro photodynamic therapy was efficient in inactivation of Fusarium spp. and Exophiala spp., both planktonic cultures and biofilms. In addition, the combination of aPDT and antifungal drugs represents an attractive alternative to the current antifungal strategies. However, further investigations are warranted for the reliable and safe application in clinical practice.
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Affiliation(s)
- Lujuan Gao
- Department of Dermatology, Zhongshan Hospital Fudan University Shanghai, China
| | - Shaojie Jiang
- Department of Gastroenterology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University Jingzhou, China
| | - Yi Sun
- Department of Dermatology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University Jingzhou, China
| | - Meiqi Deng
- The Second Clinical Medical College, Yangtze University Jingzhou, China
| | - Qingzhi Wu
- Department of Dermatology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University Jingzhou, China
| | - Ming Li
- Department of Dermatology, Zhongshan Hospital Fudan University Shanghai, China
| | - Tongxiang Zeng
- Department of Dermatology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University Jingzhou, China
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Baltazar LM, Ray A, Santos DA, Cisalpino PS, Friedman AJ, Nosanchuk JD. Antimicrobial photodynamic therapy: an effective alternative approach to control fungal infections. Front Microbiol 2015; 6:202. [PMID: 25821448 PMCID: PMC4358220 DOI: 10.3389/fmicb.2015.00202] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 02/25/2015] [Indexed: 11/17/2022] Open
Abstract
Skin mycoses are caused mainly by dermatophytes, which are fungal species that primarily infect areas rich in keratin such as hair, nails, and skin. Significantly, there are increasing rates of antimicrobial resistance among dermatophytes, especially for Trichophyton rubrum, the most frequent etiologic agent worldwide. Hence, investigators have been developing new therapeutic approaches, including photodynamic treatment. Photodynamic therapy (PDT) utilizes a photosensitive substance activated by a light source of a specific wavelength. The photoactivation induces cascades of photochemicals and photobiological events that cause irreversible changes in the exposed cells. Although photodynamic approaches are well established experimentally for the treatment of certain cutaneous infections, there is limited information about its mechanism of action for specific pathogens as well as the risks to healthy tissues. In this work, we have conducted a comprehensive review of the current knowledge of PDT as it specifically applies to fungal diseases. The data to date suggests that photodynamic treatment approaches hold great promise for combating certain fungal pathogens, particularly dermatophytes.
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Affiliation(s)
- Ludmila M Baltazar
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx NY, USA ; Department of Medicine, Albert Einstein College of Medicine, Bronx NY, USA
| | - Anjana Ray
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx NY, USA ; Department of Medicine, Albert Einstein College of Medicine, Bronx NY, USA
| | - Daniel A Santos
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais Belo Horizonte, Brazil
| | - Patrícia S Cisalpino
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais Belo Horizonte, Brazil
| | - Adam J Friedman
- Division of Dermatology, Department of Medicine, Albert Einstein College of Medicine, Bronx NY, USA ; Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx NY, USA
| | - Joshua D Nosanchuk
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx NY, USA ; Department of Medicine, Albert Einstein College of Medicine, Bronx NY, USA
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Photodynamic therapy combined with terbinafine against chromoblastomycosis and the effect of PDT on Fonsecaea monophora in vitro. Mycopathologia 2014; 179:103-9. [PMID: 25366276 DOI: 10.1007/s11046-014-9828-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
Abstract
Chromoblastomycosis, a chronic fungal infection of skin and subcutaneous tissue caused by dematiaceous fungi, is associated with low cure and high relapse rates. Among all factors affecting clinical outcome, etiological agents have an important position. In southern China, Fonsecaea pedrosoi and Fonsecaea monophora are main causative agents causing Chromoblastomycosis. We treated one case of chromoblastomycosis by photodynamic therapy (PDT) of 5-aminolevulinic acid (ALA) irradiation combined with terbinafine 250 mg a day. The lesions were improved after two sessions of ALA-PDT treatment, each including nine times, at an interval of 1 week, combined with terbinafine 250 mg/day oral, and clinical improvement could be observed. In the following study, based on the clinical treatment, the effect of PDT and antifungal drugs on this isolate was detected in vitro. It showed sensitivity to terbinafine, itraconazole or voriconazole, and PDT inhibited the growth. Both the clinic and experiments in vitro confirm the good outcome of ALA-PDT applied in the inhibition of F. monophora. It demonstrated that combination of antifungal drugs with ALA-PDT arises as a promising alternative method for the treatment of these refractory cases of chromoblastomycosis.
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17
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In vitro photodynamic inactivation of Sporothrix schenckii complex species. Med Mycol 2014; 52:770-3. [DOI: 10.1093/mmy/myu041] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Liu ZH, Xia XJ. Successful sequential treatment with itraconazole and ALA-PDT for chromoblastomycosis because ofAlternaria alternata. Dermatol Ther 2014; 27:357-60. [PMID: 25039437 DOI: 10.1111/dth.12149] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ze-Hu Liu
- Department of Dermatology; Affiliated Third Hospital of Hangzhou; Anhui Medical University; Hangzhou China
| | - Xiu-Jiao Xia
- Department of Dermatology; Affiliated Third Hospital of Hangzhou; Anhui Medical University; Hangzhou China
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Gilaberte Y, Aspiroz C, Alejandre MC, Andres-Ciriano E, Fortuño B, Charlez L, Revillo MJ, Hamblin MR, Rezusta A. Cutaneous sporotrichosis treated with photodynamic therapy: an in vitro and in vivo study. Photomed Laser Surg 2013; 32:54-7. [PMID: 24328608 DOI: 10.1089/pho.2013.3590] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sporotrichosis is a fungal infection caused by Sporothrix schenckii complex, usually restricted to the skin, subcutaneous cellular tissue, and adjacent lymphatic vessels. Antimicrobial photodynamic therapy (aPDT) could be a good alternative to manage localized, superficial infections. CASE REPORT A 65-year-old African woman was diagnosed with a fixed cutaneous sporotrichosis on her left arm, treated with itraconazol and oral terbinafine with partial improvement. Topical 16% methyl aminolevulinate (MAL, Metvix(®))-PDT was used without success. METHODS An in vitro photoinactivation test with the isolated microorganism revealed phenothiazinium salts to be more effective than MAL. CONCLUSIONS PDT with intralesional 1% methylene blue (MB) in combination with intermittent low doses of itraconazole obtained complete microbiological and clinical response.
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