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Yamada T, Yaguchi T, Salamin K, Guenova E, Feuermann M, Monod M. MFS1, a Pleiotropic Transporter in Dermatophytes That Plays a Key Role in Their Intrinsic Resistance to Chloramphenicol and Fluconazole. J Fungi (Basel) 2021; 7:542. [PMID: 34356921 PMCID: PMC8303221 DOI: 10.3390/jof7070542] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 12/25/2022] Open
Abstract
A recently identified Trichophyton rubrum major facilitator superfamily (MFS)-type transporter (TruMFS1) has been shown to give resistance to azole compounds and cycloheximide (CYH) when overexpressed in Saccharomyces cerevisiae. We investigated the roles of MFS1 in the intrinsic resistance of dermatophytes to CYH and chloramphenicol (CHL), which are commonly used to isolate these fungi, and to what extent MFS1 affects the susceptibility to azole antifungals. Susceptibility to antibiotics and azoles was tested in S. cerevisiae overexpressing MFS1 and ΔMFS1 mutants of Trichophyton benhamiae, a dermatophyte that is closely related to T. rubrum. We found that TruMFS1 functions as an efflux pump for CHL in addition to CYH and azoles in S. cerevisiae. In contrast, the growth of T. benhamiae ΔMFS1 mutants was not reduced in the presence of CYH but was severely impaired in the presence of CHL and thiamphenicol, a CHL analog. The suppression of MFS1 in T. benhamiae also increased the sensitivity of the fungus to fluconazole and miconazole. Our experiments revealed a key role of MFS1 in the resistance of dermatophytes to CHL and their high minimum inhibitory concentration for fluconazole. Suppression of MFS1 did not affect the sensitivity to CYH, suggesting that another mechanism was involved in resistance to CYH in dermatophytes.
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Affiliation(s)
- Tsuyoshi Yamada
- Teikyo University Institute of Medical Mycology, Tokyo 192-0395, Japan
- Asia International Institute of Infectious Disease Control, Teikyo University, Tokyo 173-0003, Japan
| | - Takashi Yaguchi
- Medical Mycology Research Center, Chiba University, Chiba 260-8673, Japan;
| | - Karine Salamin
- Department of Dermatology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland; (K.S.); (E.G.); (M.M.)
| | - Emmanuella Guenova
- Department of Dermatology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland; (K.S.); (E.G.); (M.M.)
- Faculty of Biology and Medicine, University of Lausanne, 1015 Lausanne, Switzerland
| | - Marc Feuermann
- Swiss-Prot Group, SIB Swiss Institute of Bioinformatics, 1205 Geneva, Switzerland;
| | - Michel Monod
- Department of Dermatology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland; (K.S.); (E.G.); (M.M.)
- Faculty of Biology and Medicine, University of Lausanne, 1015 Lausanne, Switzerland
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Tahiliani S, Saraswat A, Lahiri AK, Shah A, Hawelia D, Shah GK, Girdhar M, Rao PN, Raghav PA, Agarwal P, Kharkar RD, Gupta RP, Udare S, Hegde S, Haldar S. Etiological prevalence and antifungal sensitivity patterns of dermatophytosis in India - A multicentric study. Indian J Dermatol Venereol Leprol 2021; 87:800-806. [PMID: 34160163 DOI: 10.25259/ijdvl_1025_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The prevalence of dermatophytes varies with season, geographical area, socio-economic factors and effective management strategies. AIMS The aim of the study was to assess the prevalence of pathogenic dermatophytes, clinical types of dermatophyte fungal infection, and in vitro antifungal drug susceptibility testing against dermatophytes. METHODS Three hundred and ninety five patients with dermatophytosis were enrolled from five cities (Mumbai, Delhi, Lucknow, Kolkata and Hyderabad) across India. All patients were subjected to clinical examination and investigations, including potassium hydroxide microscopy, fungal culture and antifungal drug susceptibility testing. RESULTS Trichophyton rubrum was the most common species identified (68.4%), followed by T. mentagrophytes (29.3%). Within species, T. mentagrophytes was prevalent in humid environmental conditions (Mumbai and Kolkata), whereas T. rubrum was prevalent in noncoastal areas (Delhi, Lucknow and Hyderabad). Tinea corporis (71.4%) and tinea cruris (62.0%) were the common clinical types observed. antifungal drug susceptibility testing data indicated that minimum inhibitory concentration required to inhibit the growth of 90% of organisms (MIC-90) was lowest for griseofulvin (0.25-3.0 μg/mL). Among oral antifungals, the mean MIC of itraconazole was within the range (0.84 [0.252] μg/ mL), whereas high mean MIC values were reported for terbinafine (0.05 [0.043] μg/mL). Among topical agents, lowest mean MIC values were reported for luliconazole (0.29 [0.286] μg/mL), eberconazole (0.32 [0.251]) μg/mL and amorolfine (0.60 [0.306]) μg/mL. LIMITATIONS Lack of correlation between in vitro antifungal susceptibility and clinical outcome and absence of defined MIC breakpoints. CONCLUSION T. rubrum was the most common, followed by T. mentagrophytes as an emerging/codominant fungal isolate in India. Tinea corporis was the most common clinical type of dermatophytosis. Mean MIC of terbinafine was above the reference range, while it was within the range for itraconazole; griseofulvin had the lowest mean MIC. Luliconazole presented the lowest mean MIC values across cities.
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Affiliation(s)
- Sushil Tahiliani
- Dr. Tahiliani's Clinic, A 201/202, Gasper Enclave Ambedkar Road, Pali Market, Next to Gold's Gym, Bandra West, Mumbai, Maharashtra, India
| | - Abir Saraswat
- Indushree Skin Clinic, Near Hotel Bandhan, Faizabad Road, Indiranagar Colony, Lucknow, Uttar Pradesh, India
| | - A K Lahiri
- Skin and Laser Clinic, 204, Amsri Plaza, Sarojini Devi Road, Near to Domino's Pizza, Secunderabad, Telangana, India
| | - Avani Shah
- Dr. Miskeen's Central Clinical Microbiology Laboratory, Nirmal, 1st Floor, Behind Amrapali Hotel, Near Gadkari Rangayatan, Old Mumbai-Pune Road, Thane (West), Thane, Maharashtra, India
| | - Dinesh Hawelia
- Dr.Hawelia's Skin Clinic, 1st Floor, 245A, Chittaranjan Avenue, Kolkata, West Bengal, India
| | - G K Shah
- Skin Zone, No. 404, Vini Elegance, Above Tanishq Jewellers, L. T. Road, Borivali (West), Mumbai, Maharashtra, India
| | - Mukesh Girdhar
- Dr Mukesh Girdhar's Skin Clinic, 101, 1st Floor, Rishab Tower, Community Centre, Karkardooma, Anand Vihar, Delhi, India
| | - P Narasimha Rao
- Comprehensive Dermatology Clinic, Plot No 4, Satya Apartment, Masab Tank, Opposite Polytechnic College, Beside Golconda Hotel, Hyderabad, Telangana, India
| | - Potharaju Arun Raghav
- Comprehensive Dermatology Clinic, Plot No 4, Satya Apartment, Masab Tank, Opposite Polytechnic College, Beside Golconda Hotel, Hyderabad, Telangana, India
| | - Pramod Agarwal
- Yuva Skin and Laser Center, A-1031, A-Block, Indira Nagar, Lucknow, Uttar Pradesh, India
| | - R D Kharkar
- Dr. Kharkar's Skin Clinic, Room No 55 , 5th Floor, Dattani Chambers, S V Road, Opposite Shantinath Shopping Centre, Malad West, Mumbai, Maharashtra, India
| | - R P Gupta
- GNH Excel Medical Centre, BN-56, Jhulelal Mandir Marg, Shalimar Bagh, Block BN, Poorbi Shalimar Bag, Shalimar Bagh, Delhi, India
| | - Satish Udare
- Sparkle Skin and Aesthetic Centre, Shanti Center Building, Sector 17, Vashi, Navi Mumbai, India
| | - Sudha Hegde
- Dr. Sudha Hegade Clinic, 101, 1st Floor, Eknath Apartment, Near Paanch Rasta, Above Real Pharmacy, M G Road, Mulund (West), Mumbai, Maharashtra, India
| | - Susmit Haldar
- Calcutta Skin Institute, 169, Scheme 6 M, C I T Road, Kankurgachi, Kolkata, West Bengal, India
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Lin CJ, Chang YL, Yang YL, Chen YL. Natural alkaloid tryptanthrin exhibits novel anticryptococcal activity. Med Mycol 2020; 59:myaa074. [PMID: 32823278 DOI: 10.1093/mmy/myaa074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 12/15/2022] Open
Abstract
Cryptococcal meningitis is a prevalent invasive fungal infection that causes around 180 000 deaths annually. Currently, treatment for cryptococcal meningitis is limited and new therapeutic options are needed. Historically, medicinal plants are used to treat infectious and inflammatory skin infections. Tryptanthrin is a natural product commonly found in these plants. In this study, we demonstrated that tryptanthrin had antifungal activity with minimum inhibitory concentration (MIC) of 2 μg/ml against Cryptococcus species and of 8 μg/ml against Trichophyton rubrum. Further analysis demonstrated that tryptanthrin exerted fungistatic and potent antifungal activity at elevated temperature. In addition, tryptanthrin exhibited a synergistic effect with the calcineurin inhibitors FK506 and cyclosporine A against Cryptococcus neoformans. Furthermore, our data showed that tryptanthrin induced cell cycle arrest at the G1/S phase by regulating the expression of genes encoding cyclins and the SBF/MBF complex (CLN1, MBS1, PCL1, and WHI5) in C. neoformans. Screening of a C. neoformans mutant library further revealed that tryptanthrin was associated with various transporters and signaling pathways such as the calcium transporter (Pmc1) and protein kinase A signaling pathway. In conclusion, tryptanthrin exerted novel antifungal activity against Cryptococcus species through a mechanism that interferes with the cell cycle and signaling pathways. LAY SUMMARY The natural product tryptanthrin had antifungal activity against Cryptococcus species by interfering cell cycle and exerted synergistic effects with immunosuppressants FK506 and cyclosporine A. Our findings suggest that tryptanthrin may be a potential drug or adjuvant for the treatment of cryptococcosis.
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Affiliation(s)
- Chi-Jan Lin
- Department of Plant Pathology and Microbiology, National Taiwan University, Taipei, 10617, Taiwan
| | - Ya-Lin Chang
- Department of Plant Pathology and Microbiology, National Taiwan University, Taipei, 10617, Taiwan
| | - Yu-Liang Yang
- Agricultural Biotechnology Research Center, Academia Sinica, Taipei, 11529, Taiwan
| | - Ying-Lien Chen
- Department of Plant Pathology and Microbiology, National Taiwan University, Taipei, 10617, Taiwan
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Markantonatou AM, Samaras K, Zachrou E, Vyzantiadis TA. Comparison of Four Methods for the in vitro Susceptibility Testing of Dermatophytes. Front Microbiol 2020; 11:1593. [PMID: 32760372 PMCID: PMC7371995 DOI: 10.3389/fmicb.2020.01593] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/18/2020] [Indexed: 12/05/2022] Open
Abstract
Objectives Infections caused by dermatophytes affect a high percentage of the population. Antifungal susceptibility testing (AST) can offer useful information about the susceptibility profiles of the pathogens as well as the concomitant documentation of the appropriate treatment. However, the slow growth rate of these fungi and their poor sporulation are factors that can delay and affect the performance of the AST. The proposed methods by the CLSI or the EUCAST are both laborious for the everyday routine. There are alternative applications which propose the use of an inoculum, consisting of a conidia-mycelium mixture or even plain mycelia, as well as the use of resazurin in order to facilitate the reading. The aim of this study was to compare these approaches to the EUCAST method and evaluate their performance. Methods Three alternative methods were compared to the EUCAST proposed methodology for conidia forming molds. The last was defined as the reference method. The methods under evaluation were (a) a fragmented mycelia method, (b) the EUCAST method with the addition of resazurin sodium salt solution and (c) the fragmented mycelia method with the addition of resazurin sodium salt solution. Twenty-two isolates (8 Trichophyton interdigitale, 8 T. rubrum, and 6 Microsporum canis) were tested against the antifungal agents of griseofulvin, terbinafine, fluconazole, and itraconazole. Results The essential agreement between the methods was calculated in percentages and a statistical analysis of the results was performed. Data evaluation revealed sufficient overall agreement of the methods with the addition of resazurin to the initial “uncolored” methods (98.9 and 97.5% for the EUCAST and the fragmented mycelia methods, respectively). The fragmented mycelia method exhibited a relatively sufficient overall agreement in comparison to the EUCAST method (90%) and not a satisfactory correlation, probably as a result of various issues of standardization. Conclusion The EUCAST method was found to be the more reliable one, whereas the addition of resazurin sodium salt solution facilitates the reading and provides a reliable and objective evaluation. The fragmented mycelia method could serve as an alternative that should be applied only in cases of poor or no sporulating dermatophytes.
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Affiliation(s)
- Anthi-Marina Markantonatou
- First Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Samaras
- First Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evaggelia Zachrou
- First Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Dogra S, Shaw D, Rudramurthy SM. Antifungal Drug Susceptibility Testing of Dermatophytes: Laboratory Findings to Clinical Implications. Indian Dermatol Online J 2019; 10:225-233. [PMID: 31149563 PMCID: PMC6536077 DOI: 10.4103/idoj.idoj_146_19] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Sunil Dogra
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipika Shaw
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India E-mail:
| | - Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India E-mail:
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Aneke CI, Otranto D, Cafarchia C. Therapy and Antifungal Susceptibility Profile of Microsporum canis. J Fungi (Basel) 2018; 4:E107. [PMID: 30189676 PMCID: PMC6162526 DOI: 10.3390/jof4030107] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/28/2018] [Accepted: 08/31/2018] [Indexed: 01/25/2023] Open
Abstract
Microsporum canis is a worldwide diffused zoophilic dermatophyte which causes clinical conditions often characterised by multifocal alopecia, scaling, and circular lesions in many animal species, including humans. A large variety of oral and topical antifungal protocols is available for treating M. canis infection. However, the efficacy of these drugs and treatment protocols is variable, with treatment failure up to 40% of patients possibly due to resistance phenomena. The lack of standardised reference methods for evaluating the antifungal susceptibility of M. canis represents a major hindrance in assessing microbiological resistance in unresponsive clinical cases. Therefore, data about conventional therapy against M. canis and the protocols employed to test the antifungal activity of the most commonly employed drugs (i.e., azoles, polyenes, allylamines, and griseofulvin) have been summarised herein. This article focuses on technical parameters used for antifungal susceptibility tests, their effects on the minimum inhibitory concentration value, as well as their clinical implications.
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Affiliation(s)
- Chioma I Aneke
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", 70010 Valenzano, Bari, Italy.
- Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka 410001, Nigeria.
| | - Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", 70010 Valenzano, Bari, Italy.
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", 70010 Valenzano, Bari, Italy.
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7
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Jamison MT, Macho J, Molinski TF. Structure-activity of antifungal compounds inspired by aminobisabolenes from the sponge Halichondria sp. Bioorg Med Chem Lett 2016; 26:5244-5246. [PMID: 27720294 DOI: 10.1016/j.bmcl.2016.09.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/20/2016] [Accepted: 09/21/2016] [Indexed: 11/17/2022]
Abstract
Structure-activity relationships of the antifungal aminobisabolene natural product, 1 isolated from Halichondria sp., and synthetic analogs were explored, in parallel with the antidermatophytic allylamine, Terbinafine®, against a panel of pathogenic fungi: Candida spp., Cryptococcus spp. and Trichophyton rubrum. Interpretation of the results suggest different modes of action in antifungal activity for the two classes of compounds.
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Affiliation(s)
- Matthew T Jamison
- Department of Chemistry and Biochemistry and Pharmaceutical Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Jocelyn Macho
- Department of Chemistry and Biochemistry and Pharmaceutical Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Tadeusz F Molinski
- Department of Chemistry and Biochemistry and Pharmaceutical Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States.
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8
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Fl aacute via MLIGMJ, Ana PG, Rita CNP, Let iacute cia PP, Pollyanna FDO, Denise CT, M aacute rcio LAES, Wilson RC, Rosemeire CLRP, Ana HJAR, Patr iacute cia MCAP, Juliana DFATS, Fabiano GAES. Antifungal and cytotoxicity activities of Anacardium othonianum extract. ACTA ACUST UNITED AC 2016. [DOI: 10.5897/jmpr2016.6115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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9
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Thatai P, Sapra B. Critical review on retrospective and prospective changes in antifungal susceptibility testing for dermatophytes. Mycoses 2016; 59:615-27. [DOI: 10.1111/myc.12514] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 04/19/2016] [Accepted: 04/19/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Purva Thatai
- Division of Pharmaceutics; Department of Pharmaceutical Sciences; Punjabi University; Patiala India
| | - Bharti Sapra
- Division of Pharmaceutics; Department of Pharmaceutical Sciences; Punjabi University; Patiala India
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10
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Multilaboratory Evaluation of In Vitro Antifungal Susceptibility Testing of Dermatophytes for ME1111. J Clin Microbiol 2015; 54:662-5. [PMID: 26719434 DOI: 10.1128/jcm.03019-15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 12/23/2015] [Indexed: 11/20/2022] Open
Abstract
ME1111 is a novel small molecule antifungal agent under development for the topical treatment of onychomycosis. Standardization of the susceptibility testing method for this candidate antifungal is needed. Toward this end, 8 independent laboratories determined the interlaboratory reproducibility of ME1111 susceptibility testing. In addition, we subsequently identified 2 strains as quality control (QC) isolates for the method. In the reproducibility study, 5 blinded clinical strains each of Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum were tested, while the QC study tested 6 blinded T. rubrum or T. mentagrophytes ATCC strains. Testing was performed in frozen microtiter panels according to the Clinical and Laboratory Standards Institute (CLSI) M38-A2 methodology. In the reproducibility study, 9 of 15 clinical strains showed interlaboratory agreement of >90% at the 80% inhibition endpoint, with a range of agreement of 76.2% to 100%. In the QC study, 4 of the 6 ATCC strains showed interlaboratory agreement of >90%. ME1111 demonstrated excellent interlaboratory agreement when tested against dermatophytes. Based on this data, the CLSI Subcommittee on Antifungal Susceptibility Tests approved the susceptibility testing of ME1111 against dermatophytes according to M38-A2 methodology, which stipulates RPMI 1640 as the test medium, an inoculum size of 1 to 3 × 10(3) CFU/ml, and an incubation time and temperature of 96 h at 35°C. The MIC endpoint should be 80% inhibition compared with the growth control. T. rubrum ATCC MYA-4438 and T. mentagrophytes ATCC 28185 were selected as QC isolates, with an acceptable range of 0.12 to 1 μg/ml for the two strains.
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Rizi K, Murdan S, Danquah CA, Faull J, Bhakta S. Development of a rapid, reliable and quantitative method — “SPOTi” for testing antifungal efficacy. J Microbiol Methods 2015; 117:36-40. [DOI: 10.1016/j.mimet.2015.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 07/02/2015] [Accepted: 07/02/2015] [Indexed: 10/23/2022]
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12
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Cantón E, Espinel-Ingroff A, Pemán J. Trends in antifungal susceptibility testing using CLSI reference and commercial methods. Expert Rev Anti Infect Ther 2014; 7:107-19. [DOI: 10.1586/14787210.7.1.107] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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13
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Mercer DK, Robertson J, Wright K, Miller L, Smith S, Stewart CS, O′Neil DA. A prodrug approach to the use of coumarins as potential therapeutics for superficial mycoses. PLoS One 2013; 8:e80760. [PMID: 24260474 PMCID: PMC3832404 DOI: 10.1371/journal.pone.0080760] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 10/16/2013] [Indexed: 11/30/2022] Open
Abstract
Superficial mycoses are fungal infections of the outer layers of the skin, hair and nails that affect 20–25% of the world's population, with increasing incidence. Treatment of superficial mycoses, predominantly caused by dermatophytes, is by topical and/or oral regimens. New therapeutic options with improved efficacy and/or safety profiles are desirable. There is renewed interest in natural product-based antimicrobials as alternatives to conventional treatments, including the treatment of superficial mycoses. We investigated the potential of coumarins as dermatophyte-specific antifungal agents and describe for the first time their potential utility as topical antifungals for superficial mycoses using a prodrug approach. Here we demonstrate that an inactive coumarin glycone, esculin, is hydrolysed to the antifungal coumarin aglycone, esculetin by dermatophytes. Esculin is hydrolysed to esculetin β-glucosidases. We demonstrate that β-glucosidases are produced by dermatophytes as well as members of the dermal microbiota, and that this activity is sufficient to hydrolyse esculin to esculetin with concomitant antifungal activity. A β-glucosidase inhibitor (conduritol B epoxide), inhibited antifungal activity by preventing esculin hydrolysis. Esculin demonstrates good aqueous solubility (<6 g/l) and could be readily formulated and delivered topically as an inactive prodrug in a water-based gel or cream. This work demonstrates proof-of-principle for a therapeutic application of glycosylated coumarins as inactive prodrugs that could be converted to an active antifungal in situ. It is anticipated that this approach will be applicable to other coumarin glycones.
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Affiliation(s)
- Derry K. Mercer
- NovaBiotics Ltd, Craibstone, Bucksburn, Aberdeen, United Kingdom
- * E-mail:
| | | | - Kristine Wright
- NovaBiotics Ltd, Craibstone, Bucksburn, Aberdeen, United Kingdom
| | - Lorna Miller
- NovaBiotics Ltd, Craibstone, Bucksburn, Aberdeen, United Kingdom
| | - Shane Smith
- NovaBiotics Ltd, Craibstone, Bucksburn, Aberdeen, United Kingdom
| | - Colin S. Stewart
- NovaBiotics Ltd, Craibstone, Bucksburn, Aberdeen, United Kingdom
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Hryncewicz-Gwóźdź A, Kalinowska K, Plomer-Niezgoda E, Bielecki J, Jagielski T. Increase in resistance to fluconazole and itraconazole in Trichophyton rubrum clinical isolates by sequential passages in vitro under drug pressure. Mycopathologia 2013; 176:49-55. [PMID: 23595653 DOI: 10.1007/s11046-013-9655-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 04/10/2013] [Indexed: 11/24/2022]
Abstract
Trichophyton rubrum, an anthropophilic dermatophyte fungus, is the predominant causative agent of superficial skin infections in human population. There are only scanty reports on drug susceptibility profiling of T. rubrum. Neither mechanisms for drug resistance development nor correlation between in vitro drug susceptibility and in vivo response to treatment is known for that species. In this study, changes in the in vitro susceptibilities to fluconazole (FLZ) and itraconazole (ITZ) among thirty T. rubrum clinical strains subjected to sequential passages in the presence or absence of the azoles were investigated. Each strain was passaged 12 times at 4-week intervals as three parallel cultures, maintained on a drug-free medium (1), and a medium containing FLZ (2) or ITZ (3) at subinhibitory concentrations. Susceptibility to FLZ and ITZ of the original strain and its 3 subcultures was determined by microdilution method. The MIC values of the two azoles remained unaltered for all T. rubrum strains tested, after 12 passages on a drug-free medium. Among the strains grown with FLZ, an increase in the MICs of FLZ and ITZ was noted in 17 (56.7 %) and 19 (63.3 %) strains, respectively. Increased MICs of ITZ and FLZ were demonstrated for 24 (80 %) and 20 (66.7 %) strains that were propagated with ITZ. The results indicate the capacity of T. rubrum to develop resistance toward the azoles after prolonged exposure to these drugs. Resistance of T. rubrum to azoles plays an important role in therapy failures and consequently contributes to persistence and chronicity of the infections.
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Affiliation(s)
- Anita Hryncewicz-Gwóźdź
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
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Baltazar LDM, Soares BM, Carneiro HCS, Avila TV, Gouveia LF, Souza DG, Ferreira MVL, Pinotti M, Santos DDA, Cisalpino PS. Photodynamic inhibition of Trichophyton rubrum: in vitro activity and the role of oxidative and nitrosative bursts in fungal death. J Antimicrob Chemother 2012; 68:354-61. [DOI: 10.1093/jac/dks414] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Pothomorphe umbellata: antifungal activity against strains of Trichophyton rubrum. J Mycol Med 2012; 22:265-9. [PMID: 23518086 DOI: 10.1016/j.mycmed.2012.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 05/17/2012] [Accepted: 05/28/2012] [Indexed: 11/24/2022]
Abstract
Trichophyton rubrum is a dermatophyte, which can cause infections in human skin, hair and nail. Pothomorphe umbellata (L.) Miq. (Piperaceae) is a native Brazilian plant, in which phytochemical studies have demonstrated the presence of steroids, 4-nerolidylcatechol, sesquiterpenes and essential oils. The objective of this study was to analyze the in vitro activity of extracts and fractions of P. umbellata on resistant strains of T. rubrum. The microdilution plate method was utilized to test Tr1, H6 and ΔTruMDR2 strains of T. rubrum; ΔTruMDR2 strain was obtained from H6 by TruMDR2 gene rupture, which is involved in multiple drugs resistance. The highest antifungal activity to all strains was observed for dichloromethane and hexane fractions of the 70% ethanolic extract which showed minimal inhibitory concentration (MIC) and minimal fungicide concentration (MFC) of 78.13 μg/mL. This antifungal activity was also obtained by 70% ethanolic extract, which presented MIC and MFC of 78.13 μg/mL to ΔTruMDR2, whereas the MIC values for Tr1 and H6 were 78.13 and 156.25 μg/mL, respectively. Our results suggest the potential for future development of new antifungal drugs from P. umbellata, especially to strains presenting multiple resistance.
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Kingsbury JM, Heitman J, Pinnell SR. Calcofluor white combination antifungal treatments for Trichophyton rubrum and Candida albicans. PLoS One 2012; 7:e39405. [PMID: 22792174 PMCID: PMC3391284 DOI: 10.1371/journal.pone.0039405] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 05/24/2012] [Indexed: 12/31/2022] Open
Abstract
Superficial mycoses caused by dermatophyte fungi are among the most common infections worldwide, yet treatment is restricted by limited effective drugs available, drug toxicity, and emergence of drug resistance. The stilbene fluorescent brightener calcofluor white (CFW) inhibits fungi by binding chitin in the cell wall, disrupting cell wall integrity, and thus entails a different mechanism of inhibition than currently available antifungal drugs. To identify novel therapeutic options for the treatment of skin infections, we compared the sensitivity of representative strains of the dermatophyte Trichophyton rubrum and Candida albicans to CFW and a panel of fluorescent brighteners and phytoalexin compounds. We identified the structurally related stilbene fluorescent brighteners 71, 85, 113 and 134 as fungicidal to both T. rubrum and C. albicans to a similar degree as CFW, and the stilbene phytoalexins pinosylvan monomethyl ether and pterostilbene inhibited to a lesser degree, allowing us to develop a structure-activity relationship for fungal inhibition. Given the abilities of CFW to absorb UV(365 nm) and bind specifically to fungal cell walls, we tested whether CFW combined with UV(365 nm) irradiation would be synergistic to fungi and provide a novel photodynamic treatment option. However, while both treatments individually were cytocidal, UV(365 nm) irradiation reduced sensitivity to CFW, which we attribute to CFW photoinactivation. We also tested combination treatments of CFW with other fungal inhibitors and identified synergistic interactions between CFW and some ergosterol biosynthesis inhibitors in C. albicans. Therefore, our studies identify novel fungal inhibitors and drug interactions, offering promise for combination topical treatment regimes for superficial mycoses.
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Affiliation(s)
- Joanne M Kingsbury
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, North Carolina, United States of America.
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Krishnan-Natesan S. Terbinafine: a pharmacological and clinical review. Expert Opin Pharmacother 2009; 10:2723-33. [DOI: 10.1517/14656560903307462] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ghannoum MA, Isham NC, Chand DV. Susceptibility testing of dermatophytes. CURRENT FUNGAL INFECTION REPORTS 2009. [DOI: 10.1007/s12281-009-0018-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mota CRA, Miranda KC, Lemos JDA, Costa CR, Souza LKHE, Passos XS, Silva HME, Silva MDRR. Comparison of in vitro activity of five antifungal agents against dermatophytes, using the agar dilution and broth microdilution methods. Rev Soc Bras Med Trop 2009; 42:250-4. [DOI: 10.1590/s0037-86822009000300003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Accepted: 05/15/2009] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study was to compare the agar dilution and broth microdilution methods for determining the minimum inhibitory concentration (MIC) of fluconazole, itraconazole, ketoconazole, griseofulvin and terbinafine for 60 dermatophyte samples belonging to the species Trichophyton rubrum, Trichophyton mentagrophytes and Microsporum canis. The percentage agreement between the two methods, for all the isolates with < 2 dilutions that were tested was 91.6% for ketoconazole and griseofulvin, 88.3% for itraconazole, 81.6% for terbinafine and 73.3% for fluconazole. One hundred percent agreement was obtained for Trichophyton mentagrophytes isolates evaluated with ketoconazole and griseofulvin. Thus, until a reference method for testing the in vitro susceptibility of dermatophytes is standardized, the similarity of the results between the two methods means that the agar dilution method may be useful for susceptibility testing on these filamentous fungi.
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NB-002, a novel nanoemulsion with broad antifungal activity against dermatophytes, other filamentous fungi, and Candida albicans. Antimicrob Agents Chemother 2009; 53:3273-9. [PMID: 19433562 DOI: 10.1128/aac.00218-09] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
NB-002 is an oil-in-water emulsion designed for use for the treatment of skin, hair, and nail infections. The activity of NB-002 was compared to the activities of the available antifungal drugs against the major dermatophytes responsible for cutaneous infections, Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, and Microsporum spp., as well as 12 other genera of filamentous fungi. NB-002 consistently displayed fungicidal activity against all dermatophytes. The comparator compounds were either fungistatic or fungicidal, and for some strain-drug combinations, tolerance was observed. Assessment of the development of spontaneous resistance to NB-002 in different dermatophyte species yielded few stably resistant mutants. For filamentous nondermatophyte fungi, the MIC range varied from 0.06 to 0.5 microg/ml for Alternaria spp. to 2 to 8 microg/ml for Paecilomyes spp. NB-002 had activity against both azole-susceptible and -resistant Candida albicans yeast isolates, with MIC(90)s of 2 microg/ml, respectively, and minimum fungicidal concentrations at which 90% of isolates are inhibited of 4 and 8 microg/ml, respectively. The kinetics of the fungicidal activity of NB-002 against T. rubrum isolates were compared to those of the other antifungal drugs. NB-002 killed both mycelia and microconidia even when the fungal forms were dormant or not actively growing. Electron micrographs of mycelia and spores treated with NB-002 showed the significant disruption of the fungal structure. The in vitro broad coverage of NB-002 against filamentous fungi, dermatophytes, and C. albicans, as well as its rapid fungicidal activity, warrants further investigations to ascertain if NB-002 would be useful for the treatment of cutaneous mycoses.
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Ghannoum MA, Welshenbaugh A, Imamura Y, Isham N, Mallefet P, Yamaguchi H. Comparison of the in vitro activity of terbinafine and lanoconazole against dermatophytes. Mycoses 2009; 53:311-3. [PMID: 19422522 DOI: 10.1111/j.1439-0507.2009.01723.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The objective of this study was to compare the antifungal activity of terbinafine (TERB) with that of lanoconazole (LAN). Test isolates, which were clinical isolates of Japanese origin, included 10 strains each of Trichophyton rubrum, T. mentagrophytes and Epidermophyton floccosum. The minimum inhibitory concentration (MIC) of TERB and LAN against each dermatophyte isolate was determined according to the Clinical and Laboratory Standards Institute microbroth methodology, M38-A2. Minimum fungicidal concentrations were determined by subculturing the contents of each visibly clear well from the MIC assay for colony count. All LAN MICs were <or=0.008 microg ml(-1), while the TERB range was 0.008-0.03 microg ml(-1). Moreover, by standard definition, LAN was fungistatic against most strains, whereas TERB was fungicidal. Both LAN and TERB demonstrated potent antifungal activity against dermatophytes; however, the lack of fungicidal activity by LAN needs to be evaluated in terms of potential clinical efficacy.
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Affiliation(s)
- M A Ghannoum
- Center for Medical Mycology, University Hospital of Cleveland, Case Western Reserve University, Cleveland, OH 44106, USA.
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Ghannoum M, Wraith L, Cai B, Nyirady J, Isham N. Susceptibility of dermatophyte isolates obtained from a large worldwide terbinafine tinea capitis clinical trial. Br J Dermatol 2008; 159:711-3. [DOI: 10.1111/j.1365-2133.2008.08648.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Carrillo-Muñoz AJ, Giusiano G, Cárdenes D, Hernández-Molina JM, Eraso E, Quindós G, Guardia C, del Valle O, Tur-Tur C, Guarro J. Terbinafine susceptibility patterns for onychomycosis-causative dermatophytes and Scopulariopsis brevicaulis. Int J Antimicrob Agents 2008; 31:540-3. [DOI: 10.1016/j.ijantimicag.2008.01.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 01/20/2008] [Accepted: 01/21/2008] [Indexed: 10/22/2022]
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Antifungal resistance mechanisms in dermatophytes. Mycopathologia 2008; 166:369-83. [PMID: 18478356 DOI: 10.1007/s11046-008-9110-7] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Revised: 01/15/2008] [Accepted: 01/30/2008] [Indexed: 01/19/2023]
Abstract
Although fungi do not cause outbreaks or pandemics, the incidence of severe systemic fungal infections has increased significantly, mainly because of the explosive growth in the number of patients with compromised immune system. Thus, drug resistance in pathogenic fungi, including dermatophytes, is gaining importance. The molecular aspects involved in the resistance of dermatophytes to marketed antifungals and other cytotoxic drugs, such as modifications of target enzymes, over-expression of genes encoding ATP-binding cassette (ABC) transporters and stress-response-related proteins are reviewed. Emphasis is placed on the mechanisms used by dermatophytes to overcome the inhibitory action of terbinafine and survival in the host environment. The relevance of identifying new molecular targets, of expanding the understanding about the molecular mechanisms of resistance and of using this information to design new drugs or to modify those that have become ineffective is also discussed.
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Dunand J, Paugam A. [In vitro susceptibility of isolates of Scytalidium spp. from superficial lesions against posaconazole]. ACTA ACUST UNITED AC 2008; 56:268-71. [PMID: 18325689 DOI: 10.1016/j.patbio.2007.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Accepted: 12/14/2007] [Indexed: 11/27/2022]
Abstract
Scytalidium spp. is a dematiaceous fungi that has been frequently reported from tropical to semi subtropical regions. We distinguish two pathogenic species: S. dimidiatum and S. hyalinum which is an homologous non-pigmented mutant of S. dimidiatum. This keratinophilic mold may produce superficial disease (skin, nails) indistinguishable from dermatophytes. In Martinique, this pseudodermatophyte could represent more than 50 % of onychomycosis. Contrary to dermatophytes, the clinical response of Scytalidium spp. are typically very poor and topical treatment or systemic agents ineffective. To evaluate the potential efficacy of the new antifungal agent posaconazole, we tested in vitro 12 clinical isolates of Scytalidium spp. (seven S. dimidiatum and five S. hyalinum) against posaconazole by Etest method. For the totality of the isolates, the minimum inhibitory concentrations (MICs) were low: MICs less or equal to 0.25 microg/ml (maximum MICs of 0.25 microg/ml for S. dimidiatum and 0.032 microg/ml for S. hyalinum). These in vitro efficacy suggest that the new agent posaconazole may be a future alternative treatment.
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Affiliation(s)
- J Dunand
- Laboratoire de microbiologie, hôpital Ambroise-Paré, Boulogne-Billancourt, France
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Akram Randhawa M. Dimethyl Sulfoxide (DMSO) Inhibits the Germination of Candida albicans and the Arthrospores of Trichophyton mentagrophytes. ACTA ACUST UNITED AC 2008; 49:125-8. [DOI: 10.3314/jjmm.49.125] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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