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Sattarzadeh Badkoubeh R, Farajpour M, Salehi M, Sherafati A, Zamani Z, Rezahosseini O, Mansouri P, Sardari A. Caspofungin-Induced Cardiotoxicity in Patients Treating for Candidemia. TOXICS 2022; 10:521. [PMID: 36136486 PMCID: PMC9506447 DOI: 10.3390/toxics10090521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 06/16/2023]
Abstract
Echinocandins selectively inhibit fungal cell wall synthesis and, therefore, have few side effects. However, there are reports of hemodynamic and cardiac complications. We conducted this study to investigate the effects of caspofungin both on the noninvasive echocardiographic indices of myocardial function and myocardial injury based on serum high-sensitivity cardiac troponin I (hs-cTnI) levels. This study was conducted on patients treated for candidemia. The hs-cTnI level and echocardiographic parameters were measured before and 1 h after the infusion of the induction dose of caspofungin. Data were compared between central and peripheral venous drug administration routes. Fifteen patients were enrolled in the study. There were no significant differences in the echocardiographic parameters between the baseline and post-treatment period. The mean hs-cTnI level exhibited a significant rise following drug administration (0.24 ± 0.2 ng/mL vs 0.32 ± 0.3 ng/mL; p = 0.006). There was also a significant difference concerning the hs-cTnI level between central and peripheral venous drug administration routes (p = 0.034). Due to differences in the hs-cTnI level, it appears that the administration of caspofungin may be associated with myocardial injury. Our findings also showed a higher possibility of cardiotoxicity via the central venous administration route.
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Affiliation(s)
- Roya Sattarzadeh Badkoubeh
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran P.O. Box 14197-33141, Iran
| | - Mostafa Farajpour
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran P.O. Box 14197-33141, Iran
| | - Mohammadreza Salehi
- Department of Infectious diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran P.O. Box 14197-33141, Iran
| | - Alborz Sherafati
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran P.O. Box 14197-33141, Iran
| | - Zahra Zamani
- Department of Community Medicine, Tehran University of Medical Sciences, Tehran P.O. Box 14155-6559, Iran
| | - Omid Rezahosseini
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Pejman Mansouri
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran P.O. Box 14155-6559, Iran
| | - Akram Sardari
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran P.O. Box 14197-33141, Iran
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Koch C, Schneck E, Arens C, Markmann M, Sander M, Henrich M, Weigand MA, Lichtenstern C. Hemodynamic changes in surgical intensive care unit patients undergoing echinocandin treatment. Int J Clin Pharm 2019; 42:72-79. [DOI: 10.1007/s11096-019-00939-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 11/08/2019] [Indexed: 01/05/2023]
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Caspofungin Modulates Ryanodine Receptor-Mediated Calcium Release in Human Cardiac Myocytes. Antimicrob Agents Chemother 2018; 62:AAC.01114-18. [PMID: 30150463 DOI: 10.1128/aac.01114-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/18/2018] [Indexed: 01/21/2023] Open
Abstract
Recent studies showed that critically ill patients might be at risk for hemodynamic impairment during caspofungin (CAS) therapy. The aim of our present study was to examine the mechanisms behind CAS-induced cardiac alterations. We revealed a dose-dependent increase in intracellular Ca2+ concentration ([Ca2+]i) after CAS treatment. Ca2+ ions were found to be released from intracellular caffeine-sensitive stores, most probably via the activation of ryanodine receptors.
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Savić ND, Vojnovic S, Glišić BĐ, Crochet A, Pavic A, Janjić GV, Pekmezović M, Opsenica IM, Fromm KM, Nikodinovic-Runic J, Djuran MI. Mononuclear silver(I) complexes with 1,7-phenanthroline as potent inhibitors of Candida growth. Eur J Med Chem 2018; 156:760-773. [PMID: 30053719 DOI: 10.1016/j.ejmech.2018.07.049] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/11/2018] [Accepted: 07/17/2018] [Indexed: 01/19/2023]
Abstract
Mononuclear silver(I) complexes with 1,7-phenanthroline (1,7-phen), [Ag(NO3-O,O') (1,7-phen-N7)2] (1) and [Ag(1,7-phen-N7)2]X, X = ClO4- (2), CF3SO3- (3), BF4- (4) and SbF6- (5) were synthesized and structurally characterized by NMR (1H and 13C), IR and UV-Vis spectroscopy and ESI mass spectrometry. The crystal structures of 1, 3 and 4 were determined by single-crystal X-ray diffraction analysis. In all these complexes, 1,7-phen coordinates to the Ag(I) ion in a monodentate fashion via the less sterically hindered N7 nitrogen atom. The investigation of the solution stability of 1-5 in DMSO revealed that they are sufficiently stable in this solvent at room temperature. Complexes 1-5 showed selectivity towards Candida spp. in comparison to bacteria, effectively inhibiting the growth of four different Candida species with minimal inhibitory concentrations (MIC) between 1.2 and 11.3 μM. Based on the lowest MIC values and the lowest cytotoxicity against healthy human fibroblasts with selectivity index of more than 30, the antifungal potential was examined in detail for the complex 1. It had the ability to attenuate C. albicans virulence and to reduce epithelial cell damage in the cell infection model. Induction of reactive oxygen species (ROS) response has been detected in C. albicans, with fungal DNA being one of the possible target biomolecules. The toxicity profile of 1 in the zebrafish model (Danio rerio) revealed improved safety and activity in comparison to that of clinically utilized silver(I) sulfadiazine.
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Affiliation(s)
- Nada D Savić
- University of Kragujevac, Faculty of Science, Department of Chemistry, R. Domanovića 12, 34000 Kragujevac, Serbia
| | - Sandra Vojnovic
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11000 Belgrade, Serbia
| | - Biljana Đ Glišić
- University of Kragujevac, Faculty of Science, Department of Chemistry, R. Domanovića 12, 34000 Kragujevac, Serbia
| | - Aurélien Crochet
- Department of Chemistry, University of Fribourg, Chemin du Musée 9, CH-1700 Fribourg, Switzerland
| | - Aleksandar Pavic
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11000 Belgrade, Serbia
| | - Goran V Janjić
- Institute of Chemistry, Metallurgy and Technology, University of Belgrade, Njegoševa 12, 11000 Belgrade, Serbia
| | - Marina Pekmezović
- Department of Microbial Pathogenicity Mechanisms, Hans Knöll Institute, Jena, Germany
| | - Igor M Opsenica
- University of Belgrade-Faculty of Chemistry, Studentski trg 16, 11158 Belgrade, Serbia
| | - Katharina M Fromm
- Department of Chemistry, University of Fribourg, Chemin du Musée 9, CH-1700 Fribourg, Switzerland.
| | - Jasmina Nikodinovic-Runic
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11000 Belgrade, Serbia.
| | - Miloš I Djuran
- Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia.
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Dubler S, Laun M, Koch C, Hecker A, Weiterer S, Siegler BH, Röhrig R, Weigand MA, Lichtenstern C. The impact of real life treatment strategies for Candida peritonitis-A retrospective analysis. Mycoses 2017; 60:440-446. [PMID: 28370502 DOI: 10.1111/myc.12615] [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: 07/27/2016] [Revised: 02/16/2017] [Accepted: 02/17/2017] [Indexed: 12/29/2022]
Abstract
Candida species are commonly detected isolates from abdominal foci. The question remains as to who would benefit from early empiric treatment in cases of Candida peritonitis. This study collected real-life data on critically ill patients with Candida peritonitis to estimate the relevance of the chosen treatment strategy on the outcome of these patients. One hundred and thirty-seven surgical intensive care unit (ICU) patients with intra-abdominal invasive Candidiasis were included in the study. Fifty-six patients did not get any antifungal agent. Twenty-nine patients were empirically treated, and 52 patients were specifically treated. In the group without, with empiric and with specific antifungal treatment, the 30-day mortality rate was 33.9, 48.3 and 44.2 respectively. Candida albicans was the most frequently found species. Seven patients in the specific treatment group and one patient in the empiric treatment group emerged with candidaemia. Age, leucocyte count, APACHE II Score and acute liver failure were independent predictors of 30-day mortality in patients with Candida peritonitis. Not all patients with Candida peritonitis received antifungal treatment in real clinical practice. Patients with higher morbidity more often got antifungals. Early empirical therapy has not been associated with a better 30-day mortality.
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Affiliation(s)
- S Dubler
- Department of Anaesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - M Laun
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Giessen, Germany
| | - C Koch
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Giessen, Germany
| | - A Hecker
- Department of General, Visceral and Transplant Surgery, University Hospital of Giessen and Marburg, Giessen, Germany
| | - S Weiterer
- Department of Anaesthesiology, Heidelberg University Hospital, Heidelberg, Germany.,Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Giessen, Germany
| | - B H Siegler
- Department of Anaesthesiology, Heidelberg University Hospital, Heidelberg, Germany.,Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Giessen, Germany
| | - R Röhrig
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Giessen, Germany.,Department of Medical Informatics, Carl von Ossietzky, University Oldenburg, Oldenburg, Germany
| | - M A Weigand
- Department of Anaesthesiology, Heidelberg University Hospital, Heidelberg, Germany.,Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Giessen, Germany
| | - C Lichtenstern
- Department of Anaesthesiology, Heidelberg University Hospital, Heidelberg, Germany.,Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Giessen, Germany
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