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Heya MS, Verde-Star MJ, Rivas-Morales C, García-Hernández DG, Tijerina-Sáenz A, López-Cabanillas-Lomelí M, Álvarez-Román R, Galindo-Rodríguez SA. In vitro antifungal activity of polymeric nanoparticles loaded with Euphorbia tirucalli extract. BRAZ J BIOL 2024; 84:e275974. [PMID: 39046047 DOI: 10.1590/1519-6984.275974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 05/03/2024] [Indexed: 07/25/2024] Open
Abstract
The therapeutic potential of medicinal plants is known as an alternative in treatment of human affections; in effect, the conventional application of these medicinal sources has several limitations like low bioavailability, solubility and stability, which affect its pharmacological efficacy. In recent decades, extraordinary advances have been made in new drug delivery systems using nanocarriers. This work consisted in determining the in vitro antifungal activity of the methanolic extract of Euphorbia tirucalli formulated in polymeric nanoparticles. The antifungal activity was determined by the microdilution method in 96-well microplates, applying nanoparticles loaded with plant extract (NP-Ext) obtained by nanoprecipitation on clinical isolates of Trichophyton rubrum and T. interdigitalis. Regarding the nanoparticles, the lots used did not present significant differences in their physicochemical characteristics, with a size of 91.885 ± 1.621nm, polydispersity index of 0.152 ± 0.025 and Z-potential of -6.047 ± 0.987. The quantification of the extract in the polymeric matrix was determined by infrared spectroscopy (FTIR), where an efficiency and encapsulation percentage of 22.15 ± 0.82 and 2.95 ± 0.11, respectively, were obtained. The in vitro antifungal activity of the crude and formulated extract was obtained calculating the Minimum Inhibitory Concentration (MIC) of each one; a MIC of 125 µg/mL was obtained against T. rubrum and T. interdigitalis with the crude extract, while a MIC value of 55.55 and 0.1 µg/mL was obtained with NP-Ext, respectively, against these same. Conclusions: biological activity is closely linked to the phytochemical profile of the extract; while the improvement of said potential with the NP-Ext with the dosage form was directly related to the physicochemical characteristics of the nanocarrier.
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Affiliation(s)
- M S Heya
- Universidad Autónoma de Nuevo León, Faculty of Public Health and Nutrition, San Nicolas de los Garza, Nuevo León, México
| | - M J Verde-Star
- Universidad Autónoma de Nuevo León, Department of Chemistry, Facultad de Ciencias Biológicas, San Nicolás de los Garza, Nuevo León, Mexico
| | - C Rivas-Morales
- Universidad Autónoma de Nuevo León, Department of Chemistry, Facultad de Ciencias Biológicas, San Nicolás de los Garza, Nuevo León, Mexico
| | - D G García-Hernández
- Universidad Autónoma de Nuevo León, Department of Chemistry, Facultad de Ciencias Biológicas, San Nicolás de los Garza, Nuevo León, Mexico
| | - A Tijerina-Sáenz
- Universidad Autónoma de Nuevo León, Faculty of Public Health and Nutrition, San Nicolas de los Garza, Nuevo León, México
| | - M López-Cabanillas-Lomelí
- Universidad Autónoma de Nuevo León, Faculty of Public Health and Nutrition, San Nicolas de los Garza, Nuevo León, México
| | - R Álvarez-Román
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Departamento de Química Analítica, Monterrey 64460, Mexico
| | - S A Galindo-Rodríguez
- Universidad Autónoma de Nuevo León, Department of Chemistry, Facultad de Ciencias Biológicas, San Nicolás de los Garza, Nuevo León, Mexico
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Kane A, Rothwell JG, Guttentag A, Hainsworth S, Carter D. Bisphosphonates synergistically enhance the antifungal activity of azoles in dermatophytes and other pathogenic molds. mSphere 2024; 9:e0024824. [PMID: 38837382 PMCID: PMC11332346 DOI: 10.1128/msphere.00248-24] [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: 03/24/2024] [Accepted: 04/22/2024] [Indexed: 06/07/2024] Open
Abstract
Superficial infections of the skin, hair, and nails by fungal dermatophytes are the most prevalent of human mycoses, and many infections are refractory to treatment. As current treatment options are limited, recent research has explored drug synergy with azoles for dermatophytoses. Bisphosphonates, which are approved to treat osteoporosis, can synergistically enhance the activity of azoles in diverse yeast pathogens but their activity has not been explored in dermatophytes or other molds. Market bisphosphonates risedronate, alendronate, and zoledronate (ZOL) were evaluated for antifungal efficacy and synergy with three azole antifungals: fluconazole (FLC), itraconazole (ITR), and ketoconazole (KET). ZOL was the most active bisphosphonate tested, displaying moderate activity against nine dermatophyte species (MIC range 64-256 µg/mL), and was synergistic with KET in eight of these species. ZOL was also able to synergistically improve the anti-biofilm activity of KET and combining KET and ZOL prevented the development of antifungal resistance. Rescue assays in Trichophyton rubrum revealed that the inhibitory effects of ZOL alone and in combination with KET were due to the inhibition of squalene synthesis. Fluorescence microscopy using membrane- and ROS-sensitive probes demonstrated that ZOL and KET:ZOL compromised membrane structure and induced oxidative stress. Antifungal activity and synergy between bisphosphonates and azoles were also observed in other clinically relevant molds, including species of Aspergillus and Mucor. These findings indicate that repurposing bisphosphonates as antifungals is a promising strategy for revitalising certain azoles as topical antifungals, and that this combination could be fast-tracked for investigation in clinical trials. IMPORTANCE Fungal infections of the skin, hair, and nails, generally grouped together as "tineas" are the most prevalent infectious diseases globally. These infections, caused by fungal species known as dermatophytes, are generally superficial, but can in some cases become aggressive. They are also notoriously difficult to resolve, with few effective treatments and rising levels of drug resistance. Here, we report a potential new treatment that combines azole antifungals with bisphosphonates. Bisphosphonates are approved for the treatment of low bone density diseases, and in fungi they inhibit the biosynthesis of the cell membrane, which is also the target of azoles. Combinations were synergistic across the dermatophyte species and prevented the development of resistance. We extended the study to molds that cause invasive disease, finding synergy in some problematic species. We suggest bisphosphonates could be repurposed as synergents for tinea treatment, and that this combination could be fast-tracked for use in clinical therapy.
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Affiliation(s)
- Aidan Kane
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Joanna G. Rothwell
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Annabel Guttentag
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Steven Hainsworth
- School of Science, Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia
| | - Dee Carter
- School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, New South Wales, Australia
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3
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Maschio-Lima T, Lemes TH, Marques MDR, Siqueira JPZ, de Almeida BG, Caruso GR, Von Zeska Kress MR, de Tarso da Costa P, Regasini LO, de Almeida MTG. Synergistic activity between conventional antifungals and chalcone-derived compound against dermatophyte fungi and Candida spp. Int Microbiol 2024:10.1007/s10123-024-00541-7. [PMID: 38819732 DOI: 10.1007/s10123-024-00541-7] [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: 01/03/2024] [Revised: 05/20/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024]
Abstract
The scarce antifungal arsenal, changes in the susceptibility profile of fungal agents, and lack of adherence to treatment have contributed to the increase of cases of dermatomycoses. In this context, new antimicrobial substances have gained importance. Chalcones are precursors of the flavonoid family that have multiple biological activities, have high tolerability by humans, and easy synthesis. In this study, we evaluated the in vitro antifungal activity, alone and in combination with conventional antifungal drugs, of the VS02-4'ethyl chalcone-derived compound against dermatophytes and Candida spp. Susceptibility testing was carried out by broth microdilution. Experiments for determination of the target of the compound on the fungal cell, time-kill kinetics, and toxicity tests in Galleria mellonella model were also performed. Combinatory effects were evaluated by the checkerboard method. Results showed high activity of the compound VS02-4'ethyl against dermatophytes (MIC of 7.81-31.25 μg/ml). The compound targeted the cell membrane, and the time-kill test showed the compound continues to exert gradual activity after 5 days on dermatophytes, but no significant activity on Candida. Low toxicity was observed at 250 mg/kg. Excellent results were observed in the combinatory test, where VS02-4'ethyl showed synergistic interactions with itraconazole, fluconazole, terbinafine, and griseofulvin, against all isolates tested. Although further investigation is needed, these results revealed the great potential of chalcone-derived compounds against fungal infections for which treatments are long and laborious.
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Affiliation(s)
- Taiza Maschio-Lima
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil.
| | - Thiago Henrique Lemes
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Mariela Domiciano Ribeiro Marques
- Department of Dermatological, Infectious, and Parasitic Diseases, School of Medicine São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - João Paulo Zen Siqueira
- Department of Dermatological, Infectious, and Parasitic Diseases, School of Medicine São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | | | - Glaucia Rigotto Caruso
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Marcia Regina Von Zeska Kress
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Paulo de Tarso da Costa
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Luis Octávio Regasini
- Laboratory of Antibiotics and Chemotherapy, Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, São Paulo, Brazil
| | - Margarete Teresa Gottardo de Almeida
- Department of Dermatological, Infectious, and Parasitic Diseases, School of Medicine São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
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Ciesielska A, Kowalczyk A, Paneth A, Stączek P. Evaluation of the antidermatophytic activity of potassium salts of N-acylhydrazinecarbodithioates and their aminotriazole-thione derivatives. Sci Rep 2024; 14:3521. [PMID: 38347115 PMCID: PMC10861498 DOI: 10.1038/s41598-024-54025-9] [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: 02/07/2023] [Accepted: 02/07/2024] [Indexed: 02/15/2024] Open
Abstract
Nowadays, dermatophyte infections are relatively easy to cure, especially since the introduction of orally administered antifungals such as terbinafine and itraconazole. However, these drugs may cause side effects due to liver damage or their interactions with other therapeutics. Hence, the search for new effective chemotherapeutics showing antidermatophyte activity seems to be the urge of the moment. Potassium salts of N-acylhydrazinecarbodithioates are used commonly as precursors for the synthesis of biologically active compounds. Keeping that in mind, the activity of a series of five potassium N-acylhydrazinecarbodithioates (1a-e) and their aminotriazole-thione derivatives (2a-e) was evaluated against a set of pathogenic, keratinolytic fungi, such as Trichophyton ssp., Microsporum ssp. and Chrysosporium keratinophilum, but also against some Gram-positive and Gram-negative bacteria. All tested compounds were found non-toxic for L-929 and HeLa cells, with the IC30 and IC50 values assessed in the MTT assay above 128 mg/L. The compound 5-amino-3-(naphtalene-1-yl)-4,5-dihydro-1H-1,2,4-triazole-5-thione (2d) was found active against all fungal strains tested. Scanning Electron Microscopy (SEM) revealed inhibition of mycelium development of Trichophyton rubrum cultivated on nail fragments and treated with 2d 24 h after infection with fungal spores. Transmission Electron Microscopy (TEM) observation of mycelium treated with 2d showed ultrastructural changes in the morphology of germinated spores. Finally, the RNA-seq analysis indicated that a broad spectrum of genes responded to stress induced by the 2d compound. In conclusion, the results confirm the potential of N-acylhydrazinecarbodithioate derivatives for future use as promising leads for new antidermatophyte agents development.
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Affiliation(s)
- Anita Ciesielska
- Department of Molecular Microbiology, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland.
| | - Aleksandra Kowalczyk
- Department of Molecular Microbiology, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland
| | - Agata Paneth
- Department of Organic Chemistry, Faculty of Pharmacy with Medical Analytics Division, Medical University of Lublin, Chodźki 4a, 20-093, Lublin, Poland
| | - Paweł Stączek
- Department of Molecular Microbiology, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland
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5
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Gupta AK, Elewski B, Joseph WS, Lipner SR, Daniel CR, Tosti A, Guenin E, Ghannoum M. Treatment of onychomycosis in an era of antifungal resistance: Role for antifungal stewardship and topical antifungal agents. Mycoses 2024; 67:e13683. [PMID: 38214375 DOI: 10.1111/myc.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/02/2023] [Accepted: 11/28/2023] [Indexed: 01/13/2024]
Abstract
A growing body of literature has marked the emergence and spread of antifungal resistance among species of Trichophyton, the most prevalent cause of toenail and fingernail onychomycosis in the United States and Europe. We review published data on rates of oral antifungal resistance among Trichophyton species; causes of antifungal resistance and methods to counteract it; and in vitro data on the role of topical antifungals in the treatment of onychomycosis. Antifungal resistance among species of Trichophyton against terbinafine and itraconazole-the two most common oral treatments for onychomycosis and other superficial fungal infections caused by dermatophytes-has been detected around the globe. Fungal adaptations, patient characteristics (e.g., immunocompromised status; drug-drug interactions), and empirical diagnostic and treatment patterns may contribute to reduced antifungal efficacy and the development of antifungal resistance. Antifungal stewardship efforts aim to ensure proper antifungal use to limit antifungal resistance and improve clinical outcomes. In the treatment of onychomycosis, critical aspects of antifungal stewardship include proper identification of the fungal infection prior to initiation of treatment and improvements in physician and patient education. Topical ciclopirox, efinaconazole and tavaborole, delivered either alone or in combination with oral antifungals, have demonstrated efficacy in vitro against susceptible and/or resistant isolates of Trichophyton species, with low potential for development of antifungal resistance. Additional real-world long-term data are needed to monitor global rates of antifungal resistance and assess the efficacy of oral and topical antifungals, alone or in combination, in counteracting antifungal resistance in the treatment of onychomycosis.
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Affiliation(s)
- Aditya K Gupta
- Mediprobe Research Inc., London, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Boni Elewski
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Warren S Joseph
- Arizona College of Podiatric Medicine, Midwestern University, Glendale, Arizona, USA
| | | | - C Ralph Daniel
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Eric Guenin
- Ortho Dermatologics (a division of Bausch Health US, LLC), Bridgewater, New Jersey, USA
| | - Mahmoud Ghannoum
- Case Western Reserve University, Cleveland, Ohio, USA
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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Kruithoff C, Gamal A, McCormick TS, Ghannoum MA. Dermatophyte Infections Worldwide: Increase in Incidence and Associated Antifungal Resistance. Life (Basel) 2023; 14:1. [PMID: 38276250 PMCID: PMC10817648 DOI: 10.3390/life14010001] [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: 11/14/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
The increase in incidence of superficial fungal infections combined with the emergence of antifungal resistance represents both a global health challenge and a considerable economic burden. Recently, dermatophytes, the main culprit causing superficial fungal infections, have started to exhibit antifungal resistance. This can be observed in some of the most common species such as Trichophyton rubrum and Trichophyton mentagrophytes. Importantly, the new subspecies, known as Trichophyton indotineae, has been reported to show high resistance to terbinafine, a first-line treatment for dermatophyte infections. Compounding these issues is the realization that diagnosing the causative infectious agents requires using molecular analysis that goes beyond the conventional macroscopic and microscopic methods. These findings emphasize the importance of conducting antifungal susceptibility testing to select the appropriate antifungal necessary for successful treatment. Implementing these changes may improve clinical practices that combat resistant dermatophyte infections.
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Affiliation(s)
- Caroline Kruithoff
- Heritage College of Osteopathic Medicine, Ohio University, Cleveland, OH 44122, USA;
| | - Ahmed Gamal
- Center for Medical Mycology and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA; (A.G.); (T.S.M.)
| | - Thomas S. McCormick
- Center for Medical Mycology and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA; (A.G.); (T.S.M.)
| | - Mahmoud A. Ghannoum
- Center for Medical Mycology and Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH 44106, USA; (A.G.); (T.S.M.)
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
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7
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Fernandes C, Sousa-Baptista J, Lenha-Silva AF, Calheiros D, Correia E, Figueirinha A, Salgueiro L, Gonçalves T. Azorean Black Tea ( Camellia sinensis) Antidermatophytic and Fungicidal Properties. Molecules 2023; 28:7775. [PMID: 38067505 PMCID: PMC10707949 DOI: 10.3390/molecules28237775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The treatment of dermatophytoses, the most common human fungal infections, requires new alternatives. The aim of this study was to determine the antidermatophytic activity of the aqueous Azorean Black Tea extract (ABT), together with an approach to the mechanisms of action. The phytochemical analysis of ABT extract was performed by HPLC. The dermatophytes susceptibility was assessed using a broth microdilution assay; potential synergies with terbinafine and griseofulvin were evaluated by the checkerboard assay. The mechanism of action was appraised by the quantification of the fungal cell wall chitin and β-1,3-glucan, and by membrane ergosterol. The presence of ultrastructural modifications was studied by Transmission Electron Microscopy (TEM). The ABT extract contained organic and phenolic acids, flavonoids, theaflavins and alkaloids. It showed an antidermatophytic effect, with MIC values of 250 µg/mL for Trichophyton mentagrophytes, 125 µg/mL for Trichophyton rubrum and 500 µg/mL for Microsporum canis; at these concentrations, the extract was fungicidal. An additive effect of ABT in association to terbinafine on these three dermatophytes was observed. The ABT extract caused a significant reduction in β-1,3-glucan content, indicating the synthesis of this cell wall component as a possible target. The present study identifies the antidermatophytic activity of the ABT and highlights its potential to improve the effectiveness of conventional topical treatment currently used for the management of skin or mucosal fungal infections.
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Affiliation(s)
- Chantal Fernandes
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - José Sousa-Baptista
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- FMUC—Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Ana Filipa Lenha-Silva
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Daniela Calheiros
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- FMUC—Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Edmilson Correia
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Artur Figueirinha
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (A.F.); (L.S.)
- Associated Laboratory for Green Chemistry (LAQV) of the Network of Chemistry and Technology (REQUIMTE), University of Porto, 4099-002 Porto, Portugal
| | - Lígia Salgueiro
- Faculty of Pharmacy, Health Sciences Campus, University of Coimbra, Azinhaga de S. Comba, 3000-548 Coimbra, Portugal; (A.F.); (L.S.)
- Chemical Process Engineering and Forest Products Research Centre, Department of Chemical Engineering, Faculty of Sciences and Technology, University of Coimbra, 3030-790 Coimbra, Portugal
| | - Teresa Gonçalves
- CNC-UC—Center for Neuroscience and Cell Biology of Coimbra, University of Coimbra, 3004-504 Coimbra, Portugal; (C.F.); (J.S.-B.); (A.F.L.-S.); (D.C.); (E.C.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- FMUC—Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
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Ayed A, Essid R, Mankai H, Echmar A, Fares N, Hammami M, Sewald N, Limam F, Tabbene O. Synergistic antifungal activity and potential mechanism of action of a glycolipid-like compound produced by Streptomyces blastmyceticus S108 against Candida clinical isolates. J Appl Microbiol 2023; 134:lxad246. [PMID: 37884451 DOI: 10.1093/jambio/lxad246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 09/04/2023] [Accepted: 10/25/2023] [Indexed: 10/28/2023]
Abstract
AIM The present study aimed to investigate a novel antifungal compound produced by Streptomyces blastmyceticus S108 strain. Its effectiveness against clinical isolates of Candida species and its synergistic effect with conventional antifungal drugs were assessed, and its molecular mechanism of action was further studied against Candida albicans. METHODS AND RESULTS A newly isolated strain from Tunisian soil, S. blastmyceticus S108, showed significant antifungal activity against Candida species by well diffusion method. The butanolic extract of S108 strain supernatant exhibited the best anti-Candida activity with a minimal inhibitory concentration (MIC) value of 250 μg ml-1, determined by the microdilution method. The bio-guided purification steps of the butanolic extract were performed by chromatographic techniques. Among the fractions obtained, F13 demonstrated the highest level of activity, displaying a MIC of 31.25 μg ml-1. Gas chromatography-mass spectrometry and electrospray ionization mass spectrometry analyses of this fraction (F13) revealed the glycolipidic nature of the active molecule with a molecular weight of 685.6 m/z. This antifungal metabolite remained stable to physicochemical changes and did not show hemolytic activity even at 4MIC corresponding to 125 µg ml-1 toward human erythrocytes. Besides, the glycolipid compound was combined with 5-flucytosine and showed a high synergistic effect with a fractional inhibitory concentration index value 0.14 against C. albicans ATCC 10231. This combination resulted in a decrease of MIC values of 5-flucytosine and the glycolipid-like compound by 8- and 64-fold, respectively. The examination of gene expression in treated C. albicans cells by quantitative polymerase chain reaction (qPCR) revealed that the active compound tested alone or in combination with 5-flucytosine blocks the ergosterol biosynthesis pathway by downregulating the expression of ERG1, ERG3, ERG5, ERG11, and ERG25 genes. CONCLUSION AND IMPACT OF THE STUDY The new glycolipid-like compound, produced by Streptomyces S108 isolate, could be a promising drug for medical use against pathogenic Candida isolates.
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Affiliation(s)
- A Ayed
- Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, Hammam-Lif 2050, Tunisia
| | - R Essid
- Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, Hammam-Lif 2050, Tunisia
| | - H Mankai
- Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, Hammam-Lif 2050, Tunisia
| | - A Echmar
- Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, Hammam-Lif 2050, Tunisia
| | - N Fares
- Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, Hammam-Lif 2050, Tunisia
| | - M Hammami
- Laboratory of Aromatic and Medicinal Plants, Center of Biotechnology of Borj Cedria, Hammam-Lif 2050, Tunisia
| | - N Sewald
- Organic and Bioorganic Chemistry, Faculty of Chemistry, Bielefeld University, 33615 Bielefeld, Germany
| | - F Limam
- Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, Hammam-Lif 2050, Tunisia
| | - O Tabbene
- Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, Hammam-Lif 2050, Tunisia
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9
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Waller SB, Ripoll MK, de Melo LP, Lindemann P, Gomes ADR, Martins ODA, Cleff MB, de Mello JRB, de Faria RO, Meireles MCA. Are polar extracts and essential oil from Origanum vulgare Linn. (oregano) an alternative against itraconazole-resistant dermatophytes from veterinary cases? J Mycol Med 2023; 33:101391. [PMID: 37137171 DOI: 10.1016/j.mycmed.2023.101391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/08/2023] [Accepted: 04/24/2023] [Indexed: 05/05/2023]
Abstract
Although the conventional therapy against dermatophytosis is based on antifungal drugs and environmental disinfection, the emergence of itraconazole(ITZ)-resistant dermatophytes has encouraged the search for active compounds, such as Origanum vulgare L. (oregano) essential oil (EO). However, little is known about its effect in polar extracts or the mechanism of action of these extracts and EO. We investigated the antifungal activity of four polar extracts and one EO from oregano against ITZ-susceptible and ITZ-resistant dermatophytes and their action mechanism. Polar extracts were prepared as infusions at 10 (INF10) and 60 (INF60) minutes, decoction (DEC) and hydroalcoholic extract (HAE); EO was purchased. All extracts and itraconazole were tested against Microsporum gypseum, M. canis, M. nanum, Trichophyton mentagrophytes and T. verrucosum isolated from cats, dogs and cattle (n = 28), and humans (n = 2) (M38-A2, CLSI). Among polar extract, DEC stood out as antifungal, followed by INF10 and INF60; HAE was little active. For EO, all isolates were susceptible, including ITZ-resistant dermatophytes. EO was selected for action mechanism assays, and acted in cell wall and plasmatic membrane by complexing with fungal ergosterol. By chromatographic analysis, 4-hydroxibenzoic acid was the most prevalent compound in all polar extracts, followed by syringic acid and caffeic acid; luteolin was present only in HAE. For EO, carvacrol was the major compound (73.9%); followed by γ-terpinene (3.6%) and thymol (3.0%). These findings showed that the extract type of oregano has influenced the antifungal action on dermatophytes, highlight EO and DEC, that are promising as antifungal agent, including against ITZ-resistant dermatophytes.
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Affiliation(s)
- Stefanie Bressan Waller
- Department of Preventive Veterinary, Faculty of Veterinary, Federal University of Pelotas (UFPEL), 96010-900, Pelotas, RS, Brazil.
| | - Márcia Kutscher Ripoll
- Department of Preventive Veterinary, Faculty of Veterinary, Federal University of Pelotas (UFPEL), 96010-900, Pelotas, RS, Brazil
| | - Luciéle Pereira de Melo
- Department of Preventive Veterinary, Faculty of Veterinary, Federal University of Pelotas (UFPEL), 96010-900, Pelotas, RS, Brazil
| | - Patrícia Lindemann
- Department of Preventive Veterinary, Faculty of Veterinary, Federal University of Pelotas (UFPEL), 96010-900, Pelotas, RS, Brazil
| | - Angelita Dos Reis Gomes
- Department of Preventive Veterinary, Faculty of Veterinary, Federal University of Pelotas (UFPEL), 96010-900, Pelotas, RS, Brazil
| | - Otávia de Almeida Martins
- Department of Preventive Veterinary, Faculty of Veterinary, Federal University of Pelotas (UFPEL), 96010-900, Pelotas, RS, Brazil
| | - Marlete Brum Cleff
- Department of Veterinary Clinics, Faculty of Veterinary, Federal University of Pelotas (UFPEL), 96010-900, Pelotas, RS, Brazil
| | - João Roberto Braga de Mello
- Department of Pharmacology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), 90050-170, Porto Alegre, RS, Brazil
| | - Renata Osório de Faria
- Department of Preventive Veterinary, Faculty of Veterinary, Federal University of Pelotas (UFPEL), 96010-900, Pelotas, RS, Brazil
| | - Mário Carlos Araújo Meireles
- Department of Preventive Veterinary, Faculty of Veterinary, Federal University of Pelotas (UFPEL), 96010-900, Pelotas, RS, Brazil
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10
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Ray A, Das A, Panda S. Antifungal stewardship: What we need to know. Indian J Dermatol Venereol Leprol 2023; 89:5-11. [PMID: 36461808 DOI: 10.25259/ijdvl_91_2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022]
Abstract
Antimicrobial stewardship refers to a well-coordinated program which promotes the scientific and rational use of antimicrobials, reduces the chances of drug resistance and improves patient outcomes. A comprehensive English language literature search was done across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) for the period 1990-2022, revealing a large volume of reports of growing resistance to established antifungal therapies, against a backdrop of irrational and unscientific prescriptions. As a result of this, antifungal stewardship, a new kid on the block, has recently garnered attention. This review article is an attempt to summarise the basic concept of stewardship programs, highlighting the dire need to implement the same in the present situation of antifungal resistance and treatment failure.
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Affiliation(s)
- Arunima Ray
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
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11
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Kan S, Tan J, Cai Q, An L, Gao Z, Yang H, Liu S, Na R, Yang L. Synergistic activity of the combination of falcarindiol and itraconazole in vitro against dermatophytes. Front Cell Infect Microbiol 2023; 13:1128000. [PMID: 37207188 PMCID: PMC10189107 DOI: 10.3389/fcimb.2023.1128000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/24/2023] [Indexed: 05/21/2023] Open
Abstract
Previous studies have shown that natural polyacetylene alcohols, such as falcarindiol (FADOH), have good antifungal effects on plant fungi. While its effect on fungi that infect humans remains to be explored. In our study, checkerboard microdilution, drop-plate assay, and time-growth method were employed to analyze the interactions between FADOH and itraconazole (ITC) in vitro against dermatophytes, including 12 Trichophyton rubrum (T. rubrum), 12 Trichophyton mentagrophytes (T. mentagrophytes), and 6 Microsporum canis (M. canis). The results showed that the combination of FADOH and ITC exhibited synergistic and additive activity against 86.7% of all tested dermatophytes. FADOH had an excellent synergistic effect on ITC against T. rubrum and T. mentagrophytes; the synergistic rates were 66.7% and 58.3%, respectively. On the contrary, FADOH combined with ITC showed poor synergistic inhibitory activity (16.7%) against M. canis. Moreover, the additive rates of these two drugs against T. rubrum, T. mentagrophytes, and M. canis were 25%, 41.7%, and 33.3%, respectively. No antagonistic interactions were observed. The drop-plate assay and time-growth curves confirmed that the combination of FADOH and ITC had a potent synergistic antifungal effect. The in vitro synergistic effect of FADOH and ITC against dermatophytes is reported here for the first time. Our findings suggest the potential use of FADOH as an effective antifungal drug in the combined therapy of dermatophytoses caused especially by T. rubrum and T. mentagrophytes.
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Affiliation(s)
- Siyue Kan
- Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jingwen Tan
- Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qing Cai
- Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lulu An
- Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhiqin Gao
- Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hong Yang
- Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Siyu Liu
- Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Risong Na
- College of Plant Protection, Henan Agricultural University, Zhengzhou, China
| | - Lianjuan Yang
- Department of Medical Mycology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Lianjuan Yang,
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12
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Carmo PHF, Costa MC, Leocádio VAT, Gouveia-Eufrásio L, Emídio ECP, Pimentel SP, Paixão TA, Peres NTA, Santos DA. Exposure to itraconazole influences the susceptibility to antifungals, physiology, and virulence of Trichophyton interdigitale. Med Mycol 2022; 60:myac088. [PMID: 36367546 DOI: 10.1093/mmy/myac088] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 01/03/2024] Open
Abstract
Dermatophytosis is the most common human skin infection worldwide caused by dermatophytes, such as Trichophyton interdigitale and Trichophyton rubrum. Itraconazole (ITZ) is one of the main antifungals used to treat these infections. However, especially for onychomycosis, the treatment requires long-term regimens, increasing the possibility of drug resistance. We evaluated the effects of ITZ in the physiology, virulence, and interaction of T. interdigitale with phagocytes and mice cutaneous infection. In a screening test, fungal growth in the presence of ITZ led to the spontaneous selection of less susceptible T. interdigitale and T. rubrum strains. Interestingly, this phenotype was permanent for some T. interdigitale strains. Then, we studied three T. interdigitale strains: one susceptible and two ITZ-adapted. The ITZ-adapted strains were also less susceptible to the cell wall and membrane stressors, suggesting a multidrug resistance (MDR) phenotype associated with the increased ERG11 and MDR3 expression. These strains also presented substantial alterations in ergosterol content, lipid peroxidation, biofilm, and extracellular matrix production. During interaction with macrophages, ITZ-adapted strains were less engulfed but increased the intracellular oxidative and nitrosative bursts. In addition, ITZ-adapted strains presented a reduced ability to grow in a murine model of dermatophytosis, although causing the same tissue damage as the parental strain. In conclusion, the T. interdigitale ITZ adaptation increases tolerance to antifungals and alters the interaction with macrophages and a mammalian host. We hypothesized that successive exposure to ITZ may influence the emergence of adapted strains and lead to the recalcitrance of dermatophytosis.
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Affiliation(s)
- Paulo H F Carmo
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marliete C Costa
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Victor A T Leocádio
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ludmila Gouveia-Eufrásio
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Elúzia C P Emídio
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Samantha P Pimentel
- Departamento de Patologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Tatiane A Paixão
- Departamento de Patologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Nalu T A Peres
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Daniel A Santos
- Laboratório de Micologia, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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13
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Abuthakir MHS, Al-Dosary MA, Hatamleh AA, Alodaini HA, Perumal P, Jeyam M. Platyphylloside, a potential inhibitor from epicarp of B.aegyptiaca against CYP450 protein in T.rubrum – In vitro and in silico approaches. Saudi J Biol Sci 2022; 29:3899-3910. [PMID: 35844431 PMCID: PMC9280311 DOI: 10.1016/j.sjbs.2022.03.017] [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: 12/13/2021] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 11/28/2022] Open
Abstract
Trichophyton rubrum is one of the major disease causing pathogens in human; mainly it causes tinea pedis, tinea cruris and tinea corporis. Cytochrome P450 which considered to be an important protein that can impact ergosterol biosynthesis pathway. B. aegyptiaca is rich source of secondary metabolites with tremendous medicinal values and it has sweet pulp, leaves with spine, strong seed and oily kernel. The epicarp of the fruit was taken for this study to inhibit T. rubrum using in vitro and in silico techniques. The epicarp portion was extracted using various solvents and water. The anti-dermatophytic activity on T. rubrum of these extracts was assessed utilizing poison plate technique with 5 individual concentrations. The fractioned chloroform extract of epicarp had fully inhibited the growth of T. rubrum at 3 mg/ml. Further, the chloroform extract was subjected to LC-MS analysis, in total, 40 compounds were elucidated. Then, the derived compounds were included for predicting ADMETox properties using Qikprop module. From the analysis 40 compounds were identified to be eligible for docking process. Then the desirable compounds, drug Ketoconazole were subjected to docking analysis using Glide module of Schrödinger. It shows that Platyphylloside has better docking result than other compounds and drug Ketoconazole. Further, MD simulation was carried out for Ketoconazole-Cyp450 and Platyphylloside-CYP450 complexes using Desmond, Schrödinger. MD simulation study also confirmed that the Platyphylloside-CYP450 complex more stable. This study suggests that Platyphylloside may act as potential inhibitor and it could be further subjected to experimental analysis to inhibit the T. rubrum growth.
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Affiliation(s)
| | - Munirah Abdullah Al-Dosary
- Department of Botany and Microbiology, College of Science, King Saud University, P.O.Box 2455, Riyadh 11451, Saudi Arabia
| | - Ashraf Atef Hatamleh
- Department of Botany and Microbiology, College of Science, King Saud University, P.O.Box 2455, Riyadh 11451, Saudi Arabia
| | - Hissah Abdulrahman Alodaini
- Department of Botany and Microbiology, College of Science, King Saud University, P.O.Box 2455, Riyadh 11451, Saudi Arabia
| | - P. Perumal
- Laboratoire Information Genomique et Structurale (IGS), Marseille, France
| | - Muthusamy Jeyam
- Department of Bioinformatics, Bharathiar University, Coimbatore, Tamil Nadu, India
- Corresponding author.
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14
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Olorofim Effectively Eradicates Dermatophytes In Vitro and In Vivo. Antimicrob Agents Chemother 2021; 65:e0138621. [PMID: 34570652 DOI: 10.1128/aac.01386-21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Superficial fungal infections are prevalent worldwide, with dermatophytes as the most common cause. Various antifungal agents including azoles and allylamines are commonly used to treat dermatophytosis. However, their overuse has yielded drug-resistant strains, calling for the development of novel antimycotic compounds. Olorofim is a newly developed antifungal compound that targets pyrimidine biosynthesis in molds. The purpose of this study was to determine the in vitro and in vivo antifungal effects of olorofim against common dermatophytes. The in vitro activity of olorofim against dermatophytes was assessed by microtiter broth dilution method. Bioinformatic analysis of olorofim binding to dihydroorotate dehydrogenase (DHODH) of dermatophytes was also performed, using Aspergillus fumigatus DHODH as a template. The in vivo efficacy of the drug was investigated, using a guinea pig model, experimentally infected with Microsporum gypseum. Microtiter assays confirmed the high in vitro sensitivity of dermatophytes to olorofim (MIC = 0.015-0.06 mg/liter). Amino acid sequence analysis indicated that DHODH is highly conserved among dermatophytes. The critical residues, in dermatophytes, involved in olorofim binding were similar to their counterparts in A. fumigatus DHODH, which explains their susceptibility to olorofim. Typical skin lesions of dermatophyte infection were observed in the guinea pig model at 7 days postinoculation. Following 1 week of daily topical administration of olorofim, similar to the clotrimazole group, the skin lesions were resolved and normal hair growth patterns appeared. In light of the in vitro and in vivo activity of olorofim against dermatophytes, this novel agent may be considered as a treatment of choice against dermatophytosis.
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15
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Koehler A, Ribeiro AC, Pagani DM, Vettorato R, Magagnin CM, Stopiglia CDO, Heidrich D, Scroferneker ML. Molecular identification and antifungal susceptibility of 75 clinical isolates of Trichophyton spp. from southern Brazil. J Mycol Med 2021; 31:101201. [PMID: 34474264 DOI: 10.1016/j.mycmed.2021.101201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/08/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dermatophytoses affect more than 20% of the world's population and is caused by filamentous fungi, mainly of the genus Trichophyton. The species identification through microscopic direct examination and culture methods is challenging, with molecular presenting high sensitivity and specificity. Although there are several therapy options for dermatophyte infections, treatment failures and antifungal resistance are growing concerns. OBJECTIVE This study aimed to identify clinical isolates of Trichophyton spp. from southern Brazil using molecular methods and determine their in-vitro antifungal susceptibility. MATERIAL AND METHODS Seventy-five isolates were identified through sequencing of the ITS region. The exposure to seven antifungals drugs was performed according to protocol M28-A2 of the Clinical and Laboratory Standards Institute (CLSI). RESULTS Sixty-one isolates (81%) were identified as T. interdigitale, which differs from the epidemiological data present in the literature. Thirteen isolates were identified as T. rubrum and one as T. tonsurans. Terbinafine was the most effective antifungal, followed by itraconazole and voriconazole, which is in accordance with the results reported in previous studies. CONCLUSIONS The use of molecular methods to identify Trichophyton spp. clinical isolates and the performance of susceptibility tests are relevant to epidemiological data, identification of the emergence of antifungal resistance, and to help to translate the in-vitro antifungal susceptibility results into clinical practice.
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Affiliation(s)
- Alessandra Koehler
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Amanda Carvalho Ribeiro
- Graduate Program in Pharmacy Universdade Federal do Rio Grande do Sul. Avenida Ipiranga, 2752 - CEP, 90610-000, Porto Alegre RS, Brasil
| | - Danielle Machado Pagani
- Postgraduate Program in Agricultural and Environmental Microbiology, Universidade do Rio Grande do Sul. Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500 - CEP 90050-170, Porto Alegre RS, Brasil
| | - Rodrigo Vettorato
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Cibele Massotti Magagnin
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Cheila Denise Ottonelli Stopiglia
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Daiane Heidrich
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil
| | - Maria Lúcia Scroferneker
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - CEP, 90035-003, Porto Alegre - RS, Brasil; Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500 - CEP 90050-170, Porto Alegre RS, Brasil.
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16
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Tang Q, Yang C, Li W, Zhang Y, Wang X, Wang W, Ma Z, Zhang D, Jin Y, Lin D. Evaluation of Short-Chain Antimicrobial Peptides With Combined Antimicrobial and Anti-inflammatory Bioactivities for the Treatment of Zoonotic Skin Pathogens From Canines. Front Microbiol 2021; 12:684650. [PMID: 34456884 PMCID: PMC8386128 DOI: 10.3389/fmicb.2021.684650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/16/2021] [Indexed: 11/17/2022] Open
Abstract
The incidence of zoonotic Staphylococcus pseudintermedius and Microsporum canis infections is rapidly growing worldwide in the context of an increasing frequency of close contact between animals and humans, presenting challenges in both human and veterinary medicine. Moreover, the development of microbial resistance and emergence of recalcitrant biofilms, accompanied by the insufficiency of new antimicrobial agents, have become major obstacles in treating superficial skin infections caused by various microbes including S. pseudintermedius and M. canis. Over recent years, the prospects of antimicrobial peptides as emerging antimicrobials to combat microbial infections have been demonstrated. In our study, two novel short-chain peptides, namely, allomyrinasin and andricin B, produced by Allomyrina dichotoma and Andrias davidianus, were revealed to exhibit potent antimicrobial efficacy against clinical isolates of S. pseudintermedius and M. canis with remarkable and rapid fungicidal and bactericidal effects, while allomyrinasin exhibited inhibition of biofilm formation and eradication of mature biofilm. These peptides displayed synergistic activity when combined with amoxicillin and terbinafine against S. pseudintermedius and M. canis. Cytoplasmic leakage via cytomembrane permeabilization serves as a mechanism of action. Extremely low hemolytic activity and serum stability in vitro, as well as superior anti-infective efficacy in reducing bacterial counts and relieving the inflammatory response in vivo, were detected. The potent antibacterial, antifungal, and anti-inflammatory activities of allomyrinasin and andricin B might indicate promising anti-infective alternatives for the treatment of S. pseudintermedius and M. canis infections in the context of human and veterinary medicine.
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Affiliation(s)
- Qiyu Tang
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Chunyi Yang
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Weitian Li
- Laboratory of Anatomy of Domestic Animals, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Yuhang Zhang
- Key Lab of Animal Epidemiology and Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Xinying Wang
- Modern Animal Research Center, Nanjing University, Nanjing, China
| | - Weixin Wang
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Zhiling Ma
- Research and Development Department, Artron BioResearch Inc., Vancouver, BC, Canada
| | - Di Zhang
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Yipeng Jin
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Degui Lin
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
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17
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Brilhante RSN, Paixão GC, Pereira VS, Oliveira JSD, Maciel JM, Pereira-Neto WDA, Lima-Neto RGD, Castelo-Branco DDSCM, Cordeiro RDA, Sidrim JJC, Rocha MFG. Atypical chlamydoconidium-producing Trichophyton tonsurans strains from Ceará State, Northeast Brazil: investigation of taxonomy by phylogenetic analysis and biofilm susceptibility. MICROBIOLOGY-SGM 2021; 167. [PMID: 33427606 DOI: 10.1099/mic.0.001018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Chlamydoconidium-producing Trichophyton tonsurans strains isolated in Northeastern Brazil have morphological features different from the classic description of this dermatophyte species. This study investigated the phylogenetic relationship of chlamydoconidium-producing T. tonsurans strains isolated in Northeastern Brazil. Also, the effect of terbinafine and farnesol on mature biofilms of T. tonsurans strains was evaluated. The mass spectra of T. tonsurans strains were investigated by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The ITS and LSU loci regions of rDNA and the partial β-tubulin gene were sequenced and the phylogenetic tree was analysed. The effects of terbinafine and farnesol on mature T. tonsurans biofilms were evaluated through the analysis of metabolic activity, quantification of biomass and observation by scanning electron microscopy. MALDI-TOF MS spectra of the chlamydoconidium-producing T. tonsurans strains differed from the spectrum of the control strain (ATCC 28942), presenting an intense ion peak at m/z 4155 Da. Phylogenetic tree analysis showed that the chlamydoconidium-producing strains isolated in Northeastern Brazil are allocated to a single cluster, differing from strains isolated from other countries. As for mature T. tonsurans biofilms, farnesol reduced biomass and metabolic activity by 64.4 and 65.9 %, respectively, while terbinafine reduced the biomass by 66.5 % and the metabolic activity by 69 %. Atypical morphological characteristics presented by chlamydoconidium-producing T. tonsurans strains result from phenotypic plasticity, possibly for adaptation to environmental stressors. Also, farnesol had inhibitory activity against T. tonsurans biofilms, demonstrating this substance can be explored for development of promising anti-biofilm drugs against dermatophytes.
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Affiliation(s)
- Raimunda Sâmia Nogueira Brilhante
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
| | - Germana Costa Paixão
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
| | - Vandbergue Santos Pereira
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
| | - Jonathas Sales de Oliveira
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
| | - Juliana Maria Maciel
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
| | - Waldemiro de Aquino Pereira-Neto
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
| | | | - Débora de Souza Collares Maia Castelo-Branco
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
| | - Rossana de Aguiar Cordeiro
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
| | - José Júlio Costa Sidrim
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
| | - Marcos Fábio Gadelha Rocha
- Postgraduate Program in Veterinary Sciences, College of Veterinary, State University of Ceará. Av. Dr. Silas Munguba, 1700, Campus do Itaperi, CEP: 60714-903, Fortaleza, Ceará, Brazil.,Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Federal University of Ceará. Rua Cel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP: 60430-275, Fortaleza, Ceará, Brazil
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Yanyun C, Ying T, Wei K, Hua F, Haijun Z, Ping Z, Shunming X, Jian W. Preliminary Study on Antifungal Mechanism of Aqueous Extract of Cnidium monnieri Against Trichophyton rubrum. Front Microbiol 2021; 12:707174. [PMID: 34489895 PMCID: PMC8417377 DOI: 10.3389/fmicb.2021.707174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Trichoderma rubrum (T. rubrum) is one of the important pathogens because it is the cause of most dermatomycosis. The treatment of Trichophyton rubrum infection is time-consuming and very expensive; it is easy for the infections to reoccur, leading to therapeutic failures, persistence, and chronic infection. These issues have inspired researchers to study natural alternative therapies instead. Cnidium monnieri (L.), as a kind of traditional Chinese medicine, has a variety of pharmacological activities and a wide range of applications, so it has a high potential for researching and economic value. We detected the effect of aqueous extract of C. monnieri (L.) on the activity of T. rubrum by Cell Count Kit-8 assay (CCK-8), and we found that 128 and 256 μg/ml of aqueous extracts of C. monnieri (L.) co-cultured with T. rubrum for 24 h showed the inhibitory effect on T. rubrum. The results of scanning electron microscopy (SEM) and transmission electron microscopy (TEM) confirmed that aqueous extract of C. monnieri (L.) damaged the T. rubrum. At the same time, mass spectrometry screening with T. rubrum before and after the treatment of 256 μg/ml of aqueous extracts of C. monnieri (L.) showed that 966 differentially expressed proteins were detected, including 524 upregulated differentially expressed genes (DEGs) and 442 downregulated DEGs. The most significantly downregulated protein was chitin synthase (CHS); and the results of qRT-PCR and Western blotting demonstrated that the expression level of CHS was downregulated in the 256 μg/ml group compared with the control group. The study showed that the aqueous extract of C. monnieri (L.) could destroy the morphology of mycelia and the internal structure of T. rubrum, and it could inhibit the growth of T. rubrum. The antifungal effect of aqueous extract of C. monnieri (L.) may be related to the downregulation of the expression of CHS in T. rubrum, and CHS may be one of the potential targets of its antifungal mechanism. We concluded that aqueous extract from C. monnieri (L.) may be a potential candidate for antifungal agents.
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Affiliation(s)
- Cao Yanyun
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai, China
| | - Tang Ying
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai, China
| | - Kong Wei
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai, China
| | - Fang Hua
- Department of Clinical Laboratory, Pudong New Area People's Hospital, Shanghai, China
| | - Zhu Haijun
- Department of Emergency and Critical Care Medicine, Pudong New Area People' s Hospital, Shanghai, China
| | - Zheng Ping
- Department of Clinical Laboratory, Pudong New Area People's Hospital, Shanghai, China
| | - Xu Shunming
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai, China
| | - Wan Jian
- Department of Emergency and Critical Care Medicine, Pudong New Area People' s Hospital, Shanghai, China
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19
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Gupta AK, Venkataraman M, Renaud HJ, Summerbell R, Shear NH, Piguet V. A Paradigm Shift in the Treatment and Management of Onychomycosis. Skin Appendage Disord 2021; 7:351-358. [PMID: 34604322 PMCID: PMC8436613 DOI: 10.1159/000516112] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/17/2021] [Indexed: 11/19/2022] Open
Abstract
There is an increase in the incidence of onychomycosis, especially in at-risk populations. Onychomycosis is difficult to treat, as the efficacy of most antifungal agents is relatively low. Nondermatophyte molds (NDMs) and mixed infection (dermatophyte plus NDM) onychomycosis are contributing to growing antifungal resistance, as they are often underestimated and ignored due to incorrect diagnosis. There is a need for a paradigm shift in the management of onychomycosis to a patient-centered, holistic approach with an emphasis on laboratory diagnosis prior to initiating treatment, which enables the rational choice of the antifungal agent. Additionally, in the case of resistant infections, antifungal susceptibility testing is recommended. Strategies for effective management of onychomycosis include disinfection of fungal reservoirs in shoes and socks and prophylaxis posttreatment using topical antifungal agents. These measures may reduce the recurrence of onychomycosis and improve long-term clinical success.
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Affiliation(s)
- Aditya K. Gupta
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Mediprobe Research Inc., London, Ontario, Canada
| | | | | | - Richard Summerbell
- Sporometrics, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Neil H. Shear
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
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20
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Verma SB, Panda S, Nenoff P, Singal A, Rudramurthy SM, Uhrlass S, Das A, Bisherwal K, Shaw D, Vasani R. The unprecedented epidemic-like scenario of dermatophytosis in India: III. Antifungal resistance and treatment options. Indian J Dermatol Venereol Leprol 2021; 87:468-482. [PMID: 34219433 DOI: 10.25259/ijdvl_303_20] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/01/2020] [Indexed: 02/03/2023]
Abstract
One of the canonical features of the current outbreak of dermatophytosis in India is its unresponsiveness to treatment in majority of cases. Though there appears to be discordance between in vivo and in vitro resistance, demonstration of in vitro resistance of dermatophytes to antifungals by antifungal susceptibility testing is essential as it may help in appropriate management. The practical problem in the interpretation of antifungal susceptibility testing is the absence of clinical breakpoints and epidemiologic cutoff values. In their absence, evaluation of the upper limit of a minimal inhibitory concentration of wild type isolates may be beneficial for managing dermatophytosis and monitoring the emergence of isolates with reduced susceptibility. In the current scenario, most of the cases are unresponsive to standard dosages and duration of treatment recommended until now. This has resulted in many ex-cathedra modalities of treatment that are being pursued without any evidence. There is an urgent need to carry out methodical research to develop an evidence base to formulate a rational management approach in the current scenario.
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Affiliation(s)
| | - Saumya Panda
- Department of Dermatology, Belle Vue Clinic, Kolkata, West Bengal, India, India
| | - Pietro Nenoff
- Department of Dermatology and Laboratory Medicine, Laboratory for Medical Microbiology, Moelbis, Germany
| | - Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Shivprakash M Rudramurthy
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Silke Uhrlass
- Department of Dermatology and Laboratory Medicine, Laboratory for Medical Microbiology, Moelbis, Germany
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Kavita Bisherwal
- Department of Dermatology, Venereology and Leprosy, Lady Hardinge Medical College and SSK Hospital, Delhi
| | - Dipika Shaw
- Department of Medical Microbiology, PGI, Chandigarh, India
| | - Resham Vasani
- Department of Dermatology, Bhojani Clinic, Mumbai, Maharashtra, India
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21
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Abstract
BACKGROUND AND OBJECTIVE With the widespread use of antifungals to treat superficial mycoses, reports of antifungal resistance are increasing. Antifungal resistance is becoming a public health challenge and needs to be addressed in parallel with antibacterial and antiviral resistance. METHODS We review the growing resistance of fungal pathogens such as Trichophyton species and the emergence of novel pathogens, including multidrug-resistant strains in superficial mycoses. We also discuss the importance of laboratory diagnosis and antifungal susceptibility testing (AFST) in the management of recalcitrant infections. RESULTS AND CONCLUSION Antifungal resistance can occur naturally or develop over time when fungi are exposed to antifungals. The frequency of terbinafine-resistant Trichophyton isolates is increasing. Opportunistic pathogens such as Aspergillus and Candida species have developed resistance to classic azoles such as itraconazole and fluconazole, and the newer azoles such as posaconazole and voriconazole. Although uncommon, topical antifungals such as efinaconazole and tavaborole have shown to induce resistance in Trichophyton rubrum. The emergence of multidrug-resistant Trichophyton mentagrophytes/interdigitale, Candida auris, and Aspergillus species causing severe infections is highly concerning. Routine AFST should be considered to determine the most effective treatment, especially if there is failure to therapy. Combination treatment of oral and topical antifungals may be a consideration for managing recalcitrant infections.
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Affiliation(s)
- Aditya K Gupta
- Department of Medicine, Division of Dermatology, University of Toronto School of Medicine, Toronto, ON, Canada.,Mediprobe Research Inc., London, ON, Canada
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22
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B S C, D S P. Evaluation of efficacy and safety of oral voriconazole in the management of recalcitrant and recurrent dermatophytosis. Clin Exp Dermatol 2021; 47:30-36. [PMID: 34115896 DOI: 10.1111/ced.14799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 05/13/2021] [Accepted: 06/10/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Dermatophytosis is a worldwide public health problem, affecting > 25% of the world's population. There has been a rampant increase in the resistant, recurrent dermatophytosis in the past few years, especially in India. Azole resistance in dermatophytes has been reported to be as high as 19% worldwide, hence evaluating the efficacy and safety of a newer oral antifungal is important. AIM To evaluate the efficacy and safety of oral voriconazole in the management of recalcitrant and recurrent dermatophytosis. METHODS Patients with extensive, recurring and resistant dermatophytosis. The clinical diagnosis was confirmed by potassium hydroxide staining. Patients were given a 2-week course of oral voriconazole, administered as 800 mg on Day 1, followed by two daily doses of 200 mg (total 400 mg/day) for the remaining 13 days. The patients were followed up in Week 2 to assess response and in Week 6 to assess recurrence. Patients were monitored for any adverse effects (AEs). RESULTS In total, 40 patients completed the study. Complete clearance was seen in 90% and 75% at Weeks 2 and 6, respectively. By the end of Week 6, eight patients (20%) had partial improvement of disease without complete clearance and only 5% had recurrence. No AEs were recorded during the treatment course. CONCLUSION Voriconazole, a novel oral antifungal that can be used for treatment of recurrent and resistant dermatophytosis, has a good efficacy and safety profile with a very low rate of recurrence.
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Affiliation(s)
- Chandrashekar B S
- Department of Dermatology, Cutis Academy of Cutaneous Science, Bangalore, Karnataka, India
| | - Poojitha D S
- Department of Dermatology, Cutis Academy of Cutaneous Science, Bangalore, Karnataka, India
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23
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Jha K, Shaw D, Karim A, Narang T, Saikia B, Rudramurthy SM, Saikia UN, Dogra S. Immunological response and clinical profile in patients with recurrent dermatophytosis. Mycoses 2021; 64:1429-1441. [PMID: 34010462 DOI: 10.1111/myc.13322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 04/12/2021] [Accepted: 05/11/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND An alarming increase in the number of patients with chronic and recurrent dermatophytosis has invoked the need to study the immunological parameters of the host. OBJECTIVES To evaluate delayed type of hypersensitivity (DTH) response and immediate hypersensitivity (IH) response by flow cytometry evaluation of immune cells from peripheral blood and intradermal trichophyton skin test in patients with recurrent dermatophytosis. METHODS A hundred patients with recurrent dermatophytosis and 50 controls (healthy controls and acute dermatophytosis controls) were included. Relevant risk factors for recurrence were analysed, and serum IgE levels were estimated. Flow cytometry evaluation of immune cells in peripheral blood and intradermal trichophyton skin test was done. Dermatophyte pathogens were isolated, and antifungal susceptibility was performed. RESULTS Trichophyton mentagrophytes complex (95.84%) and T. rubrum (4.16%) were isolated in culture. Serum IgE was elevated in 83.15% cases (p = .01). IFN-γ+ cells (p = .0501, p = .0001, p = .0014), Th1 cells (p = .1197, p = .0024, p = .0169), IL-17+ cells (p = .0127, p = .0006, p = .0007) and Th17 cells (p = .0634, p = .0001, p = .0054) were reduced, and IL-4+ cells (p = .0108, p = .0175, p = .0018) were increased in cases. Intradermal test demonstrated negative DTH response in all cases (p < .001, p < .001, p < .001), strongly positive IH response in 6%, and borderline positive IH response in 85% cases (p = .018, p < .001, p < .001). Topical corticosteroids application, undergarment types (tight fit), poor frequency of washing clothes, family history of tinea, sharing of towels were significant risk factors for recurrent dermatophytosis. CONCLUSIONS Reduced IFN-γ+ , Th1, IL-17+ and Th17 cells population along with impaired DTH response by the intradermal test was observed in patients with recurrent dermatophytosis.
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Affiliation(s)
- Krishna Jha
- 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
| | - Adil Karim
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Narang
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Biman Saikia
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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24
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Dos Santos Porto D, Bajerski L, Donadel Malesuik M, Soldateli Paim C. A Review of Characteristics, Properties, Application of Nanocarriers and Analytical Methods of Luliconazole. Crit Rev Anal Chem 2021; 52:1930-1937. [PMID: 34011234 DOI: 10.1080/10408347.2021.1926219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Luliconazole is an imidazole agent, used for the treatment of fungi infection, especially dermatophytes. The mechanism of action of the drug consisting in inhibits sterol 14α-demethylase which interferes with ergosterol biosynthesis. Due to low aqueous solubility and highly lipophilic, there is a need to develop drug delivery systems (nanocarriers) capable to increase the solubility, permeability, and skin retention of luliconazole, and promote a better therapeutic effect. In this context, this review presents characteristics, properties, nanocarriers, and analytical methods used for luliconazole. From the analyzed studies, the majority reports the use of RP-HPLC techniques for luliconazole determination, but also are cited spectrophotometric UV methods. The luliconazole has been qualitatively and quantitatively analyzed in different matrices, such as raw material and pharmaceutical formulations, however, in this review, only one study was found with the luliconazole quantification biological matrix, demonstrating the lack of studies related to the quantification of the drug in biological matrices. The drug quantification in different matrices by analytical methods is of great importance since they assist in the control of the quality, efficacy, and safety of the medicine.
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Affiliation(s)
- Douglas Dos Santos Porto
- Laboratório de Pesquisa em Desenvolvimento e Controle de Qualidade; Curso de Farmácia, Universidade Federal do Pampa (UNIPAMPA - Campus Uruguaiana-RS), Uruguaiana (RS), Brasil
| | - Lisiane Bajerski
- Laboratório de Pesquisa em Desenvolvimento e Controle de Qualidade; Curso de Farmácia, Universidade Federal do Pampa (UNIPAMPA - Campus Uruguaiana-RS), Uruguaiana (RS), Brasil
| | - Marcelo Donadel Malesuik
- Laboratório de Pesquisa em Desenvolvimento e Controle de Qualidade; Curso de Farmácia, Universidade Federal do Pampa (UNIPAMPA - Campus Uruguaiana-RS), Uruguaiana (RS), Brasil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Curso de Farmácia, Universidade Federal do Pampa (UNIPAMPA - Campus Uruguaiana-RS), Uruguaiana (RS), Brasil
| | - Clésio Soldateli Paim
- Laboratório de Pesquisa em Desenvolvimento e Controle de Qualidade; Curso de Farmácia, Universidade Federal do Pampa (UNIPAMPA - Campus Uruguaiana-RS), Uruguaiana (RS), Brasil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Curso de Farmácia, Universidade Federal do Pampa (UNIPAMPA - Campus Uruguaiana-RS), Uruguaiana (RS), Brasil
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25
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Sonthalia S, Pandey A, Mehndiratta R, Agrawal M, Das S, Shreshtha S. "Azole menace"-An underappreciated trigger perpetuating the epidemic of antifungal therapeutic failure in cutaneous mycoses. Dermatol Ther 2021; 34:e14959. [PMID: 33857337 DOI: 10.1111/dth.14959] [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: 01/27/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
The South-Asian epidemic of anti-fungal therapeutic failures (AFTF) is on the rise. Although many demographic, environmental, and socioeconomic factors have been implicated in the genesis of this problem, two pharmacological issues warrant attention. While detailed discussions on the role of topical corticosteroid (TCS) in the changing landscape of the superficial mycotic infections in this region have been making headlines, another equally, rather more important pharmacological factor seems to have been undermined by the hype around TCS. The fastidious pharmacokinetic properties and related practical aspects of the triazole group of oral and topical antifungals, especially oral itraconazole seem to contribute significantly to the persistence of AFTF epidemic. In this paper, we shall discuss the broad aspects of the spectral precariousness of oral triazole antifungals with special emphasis to itraconazole, a concept known as the "azole menace" in the overall pathogenesis and tenacity of the AFTF epidemic.
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Affiliation(s)
- Sidharth Sonthalia
- Department of Dermatology & Dermatosurgery, Skinnocence: The Skin Clinic & Research Centre, Gurugram, India
| | - Amarendra Pandey
- Department of Dermatology & Laser Surgery, Cosmasure, Jabalpur, India
| | - Ruchika Mehndiratta
- Department of Dermatology & STD, Tvacha Skin & Laser Clinic, Ghaziabad, India
| | - Mahima Agrawal
- Department of Dermatology & STD, Miraderm Skin Centre, New Delhi, India
| | - Shukla Das
- Department of Microbiology, UCMS & GTB Hospital, New Delhi, India
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26
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Aneke CI, Rhimi W, Hubka V, Otranto D, Cafarchia C. Virulence and Antifungal Susceptibility of Microsporum canis Strains from Animals and Humans. Antibiotics (Basel) 2021; 10:296. [PMID: 33809233 PMCID: PMC8000290 DOI: 10.3390/antibiotics10030296] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/14/2021] [Accepted: 03/10/2021] [Indexed: 01/12/2023] Open
Abstract
The enzymatic and antifungal profiles of dermatophytes play an important role in causing infections in humans and animals. This study aimed to assess the virulence factors produced by Microsporum canis strains, in vitro antifungal profile and the relationship between virulence, antifungal profile and occurrence of lesions in animals and humans. A total of 100 M. canis strains from humans with tinea corporis (n = 10) and from animals presenting (n = 64) or not (n = 26) skin lesions was employed to evaluate phospholipase (Pz), hemolytic (Hz), lipase (Lz), catalase (Ca), and thermotolerance (GI) activities. In addition, in vitro antifungal profile was conducted using the CLSI broth microdilution method. A statistically significant difference (p < 0.05) in Lz and Ca values was revealed among strains from hosts with and without lesions. Voriconazole, terbinafine, and posaconazole were the most active drugs followed by ketoconazole, griseofulvin, itraconazole, and fluconazole in decreasing activity order. The significant positive correlation between azole susceptibility profile of M. canis and virulence factors (i.e., hemolysin and catalase) suggest that both enzyme patterns and antifungal susceptibility play a role in the appearance of skin lesions in animals and humans.
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Affiliation(s)
- Chioma Inyang Aneke
- Dipartimento di Medicina Veterinaria, Università degli Studi “Aldo Moro”, 70010 Bari, Italy; (C.I.A.); (W.R.); (D.O.)
- Department of Veterinary Pathology and Microbiology, University of Nigeria, 410001 Nsukka, Nigeria
| | - Wafa Rhimi
- Dipartimento di Medicina Veterinaria, Università degli Studi “Aldo Moro”, 70010 Bari, Italy; (C.I.A.); (W.R.); (D.O.)
| | - Vit Hubka
- Department of Botany, Faculty of Science, Charles University, 12801 Prague, Czech Republic;
- Laboratory of Fungal Genetics and Metabolism, Institute of Microbiology of the Academy of Sciences, 14220 Prague, Czech Republic
| | - Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi “Aldo Moro”, 70010 Bari, Italy; (C.I.A.); (W.R.); (D.O.)
- Faculty of Veterinary Sciences, Bu-Ali Sina University, 6517658978 Hamedan, Iran
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi “Aldo Moro”, 70010 Bari, Italy; (C.I.A.); (W.R.); (D.O.)
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27
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Danial AM, Medina A, Magan N. Lactobacillus plantarum strain HT-W104-B1: potential bacterium isolated from Malaysian fermented foods for control of the dermatophyte Trichophyton rubrum. World J Microbiol Biotechnol 2021; 37:57. [PMID: 33625606 PMCID: PMC7904726 DOI: 10.1007/s11274-021-03020-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 02/10/2021] [Indexed: 12/04/2022]
Abstract
The objective was to screen and evaluate the anti-fungal activity of lactic acid bacteria (LABs) isolated from Malaysian fermented foods against two Trichophyton species. A total of 66 LAB strains were screened using dual culture assays. This showed that four LAB strains were very effective in inhibiting growth of T. rubrum but not T. interdigitale. More detailed studies with Lactobacillus plantarum strain HT-W104-B1 showed that the supernatant was mainly responsible for inhibiting the growth of T. rubrum. The minimum inhibitory concentration (MIC), inhibitory concentration, the 50% growth inhibition (IC50) and minimum fungicide concentration (MFC) were 20 mg/mL, 14 mg/mL and 30 mg/mL, respectively. A total of six metabolites were found in the supernatant, with the two major metabolites being L-lactic acid (19.1 mg/g cell dry weight (CDW)) and acetic acid (2.2 mg/g CDW). A comparative study on keratin agar media showed that the natural mixture in the supernatants predominantly contained L-lactic and acetic acid, and this significantly controlled the growth of T. rubrum. The pure two individual compounds were less effective. Potential exists for application of the natural mixture of compounds for the treatment of skin infection by T. rubrum.
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Affiliation(s)
- Azlina Mohd Danial
- Applied Mycology Group, Environment and AgriFood Theme, Cranfield University, Cranfield, Bedford, MK43 0AL, UK.,Science and Food Technology Research Centre, Malaysian Agricultural and Research Institute, 43400, Serdang, Selangor, Malaysia
| | - Angel Medina
- Applied Mycology Group, Environment and AgriFood Theme, Cranfield University, Cranfield, Bedford, MK43 0AL, UK
| | - Naresh Magan
- Applied Mycology Group, Environment and AgriFood Theme, Cranfield University, Cranfield, Bedford, MK43 0AL, UK.
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28
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Santos Júnior CJD, Melo ARDL, Nascimento JMDD, Silva SMTD, Araújo MADS, Souza AKP. Evaluation of susceptibility and response in the surface of agents of surface mycoses (Trichophyton mentagrophytes; T. tonsurans) to antifungal drugs of interest in a medical clinic. ABCS HEALTH SCIENCES 2021. [DOI: 10.7322/abcshs.2019162.1431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Introduction: The resistance of fungal species to drugs usually used in clinics is of great interest in the medical field. Objective: To evaluate susceptibility and in vitro response of species of Trichophyton spp. to antifungal drugs of interest in clinical medicine. Methods: 12 samples of clinical isolates from humans were used, nine of T. mentagrophytes and three of T. tonsurans. Susceptibility tests were performed according to the agar diffusion (AD) and broth microdilution (BM) methods. Results: In the AD method, the species T. tonsurans presented a percentage of sensitivity of 33% in relation to amphotericin B and 66% to itraconazole, with 100% resistance to ketoconazole and fluconazole. T. mentagrophytes also showed 100% resistance to ketoconazole in this technique, with 11% sensitivity to ketoconazole, 22% to itraconazole and 22% of samples classified as sensitive dose dependent. In the MC method, the species T. tonsurans presented a sensitivity percentage of 66%, 55% and 33% in relation to ketoconazole, fluconazole and itraconazole, respectively. The T. mentagrophytes species presented sensitivity percentages of 11%, 11%, 33% and 55% for amphotericin B, itraconazole, ketoconazole and fluconazole, respectively. Conclusion: There was resistance in vitro of the species of T. mentagrophytes and T. tonsurans against the antifungal fluconazole and relative resistance against ketoconazole in the AD method. In BM, however, important percentages of sensitivity were observed for the two species analyzed in relation to the antifungals fluconazole and ketoconazole when compared to itraconazole and amphotericin B.
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Mercer DK, Robertson JC, Miller L, Stewart CS, O'Neil DA. NP213 (Novexatin®): A unique therapy candidate for onychomycosis with a differentiated safety and efficacy profile. Med Mycol 2020; 58:1064-1072. [PMID: 32232410 PMCID: PMC7657096 DOI: 10.1093/mmy/myaa015] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/18/2020] [Accepted: 02/28/2020] [Indexed: 12/17/2022] Open
Abstract
NP213 (Novexatin®) is a novel antifungal peptide specifically designed for the topical treatment of onychomycosis. NP213 was designed using host defense peptides (HDP), essential components of the innate immune response to infection, as a template. NP213 is a water-soluble cyclic fungicidal peptide that effectively penetrates human nail. NP213 demonstrated a promising preclinical and clinical safety profile, with no evidence of systemic exposure following topical application to the skin and nails. NP213 was efficacious in two phase IIa human trials with 43.3% of patients having no fungi detectable by culture of fragments from NP213-treated nails after 180 days in the first study and likewise 56.5% of patients were culture negative for dermatophytes after 360 days in the second phase IIa study. In both trials, NP213 was applied daily for only 28 days in marked contrast to other topical onychomycosis treatments that require application for up to 52 weeks. Patient reported outcomes from the phase IIa studies were positive with participants recording an improved appearance of their nails after only 14 days of application. All fungi identified in these studies were Trichophyton spp. NP213 (Novexatin®) is a promising, highly differentiated peptide-based candidate for the topical treatment of onychomycosis, addressing the infectious cause and cosmetic issues of this very common condition.
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Affiliation(s)
- Derry K Mercer
- NovaBiotics Ltd, Bridge of Don, Aberdeen, United Kingdom
| | | | - Lorna Miller
- NovaBiotics Ltd, Bridge of Don, Aberdeen, United Kingdom
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Kermani F, Javidnia J, Hedayati MT, Abastabar M, Haghani I, Didehdar M, Fami Zaghrami M, Shokohi T. In vitro activities of antifungal drugs against a large collection of Trichophyton tonsurans isolated from wrestlers. Mycoses 2020; 63:1321-1330. [PMID: 32854165 DOI: 10.1111/myc.13172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Trichophyton tonsurans is the most common agent causing tinea gladiatorum in wrestlers, and limited data on susceptibility profiles of Trichophyton tonsurans are available. OBJECTIVES We aimed to assess the in vitro activity of the common antifungal drug against a large collection of T tonsurans. MATERIALS/METHODS The in vitro activities to eight common antifungal drugs (sertaconazole, itraconazole, clotrimazole, fluconazole, butenafine, tolnaftate, terbinafine and griseofulvin) against 128 clinical isolates of T tonsurans strains, obtained from wrestlers with dermatophytosis, were performed according to CLSI M38-A2 broth microdilution document. RESULTS The geometric mean minimum inhibitory concentration was the lowest for tolnaftate (0.022 µg/mL), followed by itraconazole (0.026 µg/mL), terbinafine (0.033 µg/mL), butenafine (0.088 µg/mL), griseofulvin (0.566 µg/mL), sertaconazole (2.875 µg/mL), clotrimazole (3.419 µg/mL) and fluconazole (12.540 µg/mL). CONCLUSIONS Evaluation of antifungal susceptibility of dermatophytes showed that tolnaftate and itraconazole were the most effective drugs against T tonsurans and fluconazole had the least effect.
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Affiliation(s)
- Firoozeh Kermani
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Javad Javidnia
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad T Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mojtaba Didehdar
- Department of Medical Mycology and Parasitology, Arak University of Medical Sciences, Arak, Iran
| | | | - Tahereh Shokohi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Aneke CI, Rhimi W, Otranto D, Cafarchia C. Comparative evaluation of E-test and CLSI methods for Itraconazole, Fluconazole and Ketoconazole susceptibilities of Microsporum canis strains. Mycopathologia 2020; 185:495-502. [PMID: 32468154 DOI: 10.1007/s11046-020-00453-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/04/2020] [Indexed: 02/03/2023]
Abstract
The incidence of resistance to antifungal agents for dermatophytes is increasing, but most of the methods currently available to test the antifungal susceptibility of Microsporum canis still require standardization. The aims of this study were: (i) to evaluate the antifungal susceptibility of M. canis strains recovered from animals to ketoconazole (KTZ), fluconazole (FLZ) and itraconazole (ITZ) using a modified CLSI broth microdilution (CLSI M38-A2-BMD) and the E-test® protocols and (ii) to estimate the agreement between the methods. Tentative azole epidemiological cutoff values (ECVs) were also proposed in order to interpret the results of in vitro susceptibility tests and to establish the agreement between the E-test and CLSI BMD methods. A total of forty clinical M. canis strains from animals with skin lesions were tested, and the essential (EA) and categorical agreement (CA) between the two methods were determined. KTZ displayed the lowest MIC values, while ITZ and FLZ the highest. The ECV for KTZ and ITZ were 4 μg/ml, while those of FLZ was 64 μg/ml. Based on ECVs, about 88% of M. canis strains were susceptible to all azoles being a cross-resistance with ITZ-FLZ registered for one strain. A total of five M. canis strains showed MIC > ECV for FLZ using CLSI, while one strain showed MIC > ECV for ITZ using both tests. KTZ, ITZ and FLZ showed EA ranging from 92.5 to 95%, for all azoles and CA > 97% except for FLZ (87.5%). The good CA between the E-test and the CLSI BMD provides evidence of the reliability of the former method to test the antifungal susceptibility of M. canis for ITZ and KTZ and not for FLZ.
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Affiliation(s)
- Chioma Inyang 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
| | - Wafa Rhimi
- Dipartimento Di Medicina Veterinaria, Università Degli Studi "Aldo Moro", 70010, Valenzano (Bari), Italy
| | - 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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Aneke CI, Rhimi W, Pellicoro C, Cantacessi C, Otranto D, Cafarchia C. The best type of inoculum for testing the antifungal drug susceptibility of Microsporum canis: In vivo and in vitro results. Mycoses 2020; 63:711-716. [PMID: 32299129 DOI: 10.1111/myc.13090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/03/2020] [Accepted: 04/09/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Data correlating in vitro drug susceptibility of Microsporum canis with clinical outcomes of its infections are lacking as well as the most suitable inoculum and incubation time in broth microdilution assays. OBJECTIVES AND METHODS Microsporum canis strains were collected from animal hosts that tested positive (Group I; n = 13) and negative (Group II; n = 14) to this pathogen following itraconazole (ITC) therapy. In vitro ITC susceptibility was assessed according to the Clinical Laboratory Standards Institute (CLSI M38-A2) methodology using conidia, hypha-conidia and arthroconidia at 3 and 7 days of incubation in order to assess the most suitable inoculum and incubation time. Successively, ketoconazole (KTC), voriconazole (VRC), terbinafine (TRB), posaconazole (PSZ), fluconazole (FLC) and griseofulvin (GRI) susceptibilities were assessed using the chosen inoculum. RESULTS The MIC values of ITC after three-day incubation were equal than those recorded after 7-day incubation. Itraconazole MICs were ≤1 μg/mL for strains from Group II and >1 μg/mL for those of Group II only when conidia were used. All strains showed high susceptibility to VRC, POS, TEB and low susceptibility to ITC, KTC, GRI and FLC regardless of the source and incubation time. CONCLUSIONS AND CLINICAL IMPORTANCE Results suggest that correlation between the in vitro results and clinical outcome was observed only by incubating conidia for 3 days at 30 ± 2°C. These conditions might be most suitable to assess in vitro susceptibility of M. canis and assist in determining the occurrence of drug resistance and cross-resistance phenomena.
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Affiliation(s)
- Chioma Inyang Aneke
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Valenzano (Bari), Italy.,Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Nigeria
| | - Wafa Rhimi
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Valenzano (Bari), Italy
| | | | - Cinzia Cantacessi
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Valenzano (Bari), Italy
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Valenzano (Bari), Italy
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Cock IE, Van Vuuren SF. A review of the traditional use of southern African medicinal plants for the treatment of fungal skin infections. JOURNAL OF ETHNOPHARMACOLOGY 2020; 251:112539. [PMID: 31899200 DOI: 10.1016/j.jep.2019.112539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/23/2019] [Accepted: 12/30/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Human dermatophyte infections are one of the most common classes of infection globally, with an estimated 1.7 billion people contracting at least one infection annually. Southern African ethnic groups used multiple plants to treat dermatophytosis and to alleviate the symptoms, yet the anti-dermatophyte properties of most species remain poorly explored. AIM OF THE STUDY Our study aimed to critically review the literature to document southern African plant species used to treat one or more dermatophytic infections, and to summarise scientific evaluations of these and other plant species. Our study aims to stimulate and focus future studies in this field. MATERIALS AND METHODS A thorough review of the ethnobotanical books, reviews and primary scientific studies were undertaken to identify southern African plants used traditionally to treat dermatophytosis, thereby identifying gaps in the research requiring further study. RESULTS Eighty-nine southern African plant species are recorded as traditional therapies for dermatophytosis. Scientific evaluations of 140 plant species were identified, although most of the species in those studies were selected for reasons apart from their traditional uses. None of those studies examined the mechanism of action of the plant species, and only a single study screened the extracts for toxicity. CONCLUSIONS Despite southern Africa having some of the longest continuous human civilisations globally, as well as unique and diverse flora, and good ethnobotanical records, the anti-dermatophyte properties of southern African medicinal plants remains relatively poorly explored. The efficacy of the majority of plants used traditionally to treat fungal skin disease are yet to be verified and substantial further research is required in this field.
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Affiliation(s)
- I E Cock
- School of Environment and Science, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia; Environmental Futures Research Institute, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia.
| | - S F Van Vuuren
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Gauteng, 2193, South Africa
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Behnam M, Zarrinfar H, Najafzadeh MJ, Naseri A, Jarahi L, Babič MN. Low in vitro activity of sertaconazole against clinical isolates of dermatophyte. Curr Med Mycol 2020; 6:36-41. [PMID: 32420506 PMCID: PMC7217247 DOI: 10.18502/cmm.6.1.2507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background and Purpose: Dermatophytes are a group of fungi specialized in invading humans and other vertebrate keratinized tissues. These fungi cause a variety of skin, nail, and hair disorders, called dermatophytosis (tinea). In some cases, drug resistance to antifungals necessitates special treatment. Among the antifungal agents, sertaconazole (i.e., a third-generation imidazole) has a broad-spectrum against dermatophyte species. Regarding this, the present study was conducted to investigate the antifungal susceptibility of dermatophytes obtained from patients with dermatophytosis in Mashhad located in northeastern Iran. Materials and Methods: A total of 75 clinical dermatophyte isolates, including Trichophyton mentagrophytes (n=21), T. interdigital (n=18), T. tonsurans (n=16), Epidermophyton floccosum (n=11), Microsporum canis (n=5), Nannizzia fulvum (n=2), T. benhamiae (n=1), and T. verrucosum (n=1), were evaluated against five antifungal agents of sertaconazole, itraconazole, clotrimazole, terbinafine, and griseofulvin based on the CLSI M38-A2 guideline. Results: According to the results, the minimum inhibitory concentration (MIC) ranges ofsertaconazole, terbinafine, griseofulvin, itraconazole, and clotrimazole were estimated at 0.125-16, 0.002-1, 0.5-4, 0.031-4, and 0.016-4 µg/ml, respectively, for dermatophyte species. In addition, the geometric mean (GM) values of the MIC of sertaconazole, terbinafine, griseofulvin, itraconazole, and clotrimazole were obtained as 3.39, 1, 1.44, 1.52, and 1.93, respectively. Conclusion: Among the tested antifungals, terbinafine and griseofulvin were the most effective agents against dermatophyte isolates. However, sertaconazole, a third-generation imidazole, did not show any significant effect. Furthermore, M. canis and E. floccosum showed the best response to the antifungal agents.
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Affiliation(s)
- Mahsa Behnam
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Javad Najafzadeh
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Naseri
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Lida Jarahi
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monika Novak Babič
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
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Ponte HAS, Lima MIDO, Lima EDO, Pereira FDO. Linalool modulates dermatophyte susceptibility to azole drugs. Med Mycol 2020; 58:272-274. [PMID: 31329906 DOI: 10.1093/mmy/myz041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/02/2019] [Accepted: 04/06/2019] [Indexed: 02/06/2023] Open
Abstract
This study investigated the monoterpene linalool and its resistance modulating activity involving ergosterol biosynthesis inhibitors (ketoconazole, fluconazole, and itraconazole) in strains of Microsporum spp. and Trichophyton spp. The minimum inhibitory concentration (MIC) of test-drugs were determined by microdilution. The modulating effect of linalool was evaluated by determining the MIC of the antifungals in the presence of subinhibitory concentrations of linalool. We also investigated the association effect (checkerboard) of linalool together with ketoconazole and itraconazole. The fungi became more sensitive to ketoconazole and itraconazole in the presence of linalool. The linalool and azole drug associations presented synergism.
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Affiliation(s)
- Hellen Aparecida Silva Ponte
- Laboratory of Biochemistry, Academic Unit of Health, Education and Health Center, Federal University of Campina Grande, Cuité, Brazil
| | - Maria Islaine de Oliveira Lima
- Laboratory of Biochemistry, Academic Unit of Health, Education and Health Center, Federal University of Campina Grande, Cuité, Brazil
| | - Edeltrudes de Oliveira Lima
- Laboratory of Mycology, Department of Pharmaceutical Science, Health Sciences Center, Federal University of Paraıba, João Pessoa, Brazil
| | - Fillipe de Oliveira Pereira
- Laboratory of Biochemistry, Academic Unit of Health, Education and Health Center, Federal University of Campina Grande, Cuité, Brazil
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Salehi Z, Fatahi N, Taran M, Izadi A, Badali H, Hashemi SJ, Rezaie S, Daie Ghazvini R, Ghaffari M, Aala F, Barac A, Khodavaisy S. Comparison of in vitro antifungal activity of novel triazoles with available antifungal agents against dermatophyte species caused tinea pedis. J Mycol Med 2020; 30:100935. [PMID: 32139093 DOI: 10.1016/j.mycmed.2020.100935] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Dermatophytes are a group of keratinophilic fungi that invade and infect the keratinized tissues and cause dermatophytosis. We investigated effectiveness of novel triazole (luliconazole and lanaconazole) in comparison with available antifungal agents against dermatophyte species isolated from patients with tinea pedis. MATERIAL AND METHODS A total of 60 dermatophytes species were isolated from the patients with tinea pedis. Identification of species was done by DNA sequencing of the ITS1-5.8S rDNA-ITS2 rDNA region. In vitro antifungal susceptibility testing with luliconazole and lanaconazole and available antifungal agent was done in accordance with the Clinical and Laboratory Standards Institute, M38-A2 document. RESULTS In all investigated isolates, luliconazole had the lowest minimum inhibitory concentration (MIC) (MIC range=0.0005-0.004μg/mL), while fluconazole (MIC range=0.4-64μg/mL) had the highest MICs. Geometric mean MIC was the lowest for luliconazole (0.0008μg/mL), followed by lanoconazole (0.003μg/mL), terbinafine (0.019μg/mL), itraconazole (0.085 μg/mL), ketoconazole (0.089μg/mL), econazole (0.097μg/mL), griseofulvin (0.351 μg/mL), voriconazole (0.583μg/mL) and fluconazole (11.58μg/mL). CONCLUSION The novel triazoles showed potent activity against dermatophytes and promising candidates for the treatment of tinea pedis caused by Trichophyton and Epidermophyton species. However, further studies are warranted to determine the clinical implications of these investigations.
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Affiliation(s)
- Z Salehi
- Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - N Fatahi
- Microbiology Laboratory, Department of Biology, Faculty of Science, Razi University, Kermanshah, Iran
| | - M Taran
- Microbiology Laboratory, Department of Biology, Faculty of Science, Razi University, Kermanshah, Iran
| | - A Izadi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - H Badali
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Invasive Fungi Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - S J Hashemi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - S Rezaie
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - R Daie Ghazvini
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Ghaffari
- Department of Microbiology, Faculty of Science, Islamic Azad University, Varamin-Pishva, Iran
| | - F Aala
- Department of Parasitology and Mycology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - A Barac
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - S Khodavaisy
- Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran; Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Erdogan FG, Yıldırım D, Çakır Akay GA. Onychomycosis Unresponsive to Antifungals: Etiology and Treatment with a New Direct Technique. Indian J Dermatol 2020; 64:476-481. [PMID: 31896847 PMCID: PMC6862374 DOI: 10.4103/ijd.ijd_453_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aims and Objectives: The aim of this study was to identify the fungal agents causing onychomycosis that were unresponsive to antifungal treatment and to treat these cases by placing under-nail cushions with a mild keratolytic to clear the fungus-invaded tissue. Materials and Methods: Fungal agents were identified by the matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) technique. Results: Nine patients had Aspergillus spp. (7 Aspergillus niger, 2 Aspergillus flavus); four had Candida species and one had Trichophyton rubrum. All patients were free of infection at the end of treatment. Conclusion: As per the results, we may state that onychomycosis that is unresponsive to treatment in immunocompetent patients seems to be mostly associated with molds. Direct application of a mild keratolytic to the fungus-invaded part, e.g., the nail plate and/or nail bed and removal of fungal elements may provide a successful treatment outcome.
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38
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Aneke CI, Rhimi W, Otranto D, Cafarchia C. Synergistic Effects of Efflux Pump Modulators on the Azole Antifungal Susceptibility of Microsporum canis. Mycopathologia 2020; 185:279-288. [PMID: 31894500 DOI: 10.1007/s11046-019-00419-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 12/14/2019] [Indexed: 02/07/2023]
Abstract
The microbiologic and clinical resistance of dermatophytes is seldom reported, and the mechanisms associated with resistance are not well known. This study investigated the effect of efflux pump modulators (EPMs) (i.e., haloperidol HAL and promethazine PTZ) and their inhibiting activity on the minimum inhibitory concentrations of itraconazole (ITZ) and fluconazole (FLZ) against selected M. canis strains. M. canis strains with low (≤ 1 μg/ml itraconazole and < 64 μg/ml fluconazole) and high (> 1 μg/ml itraconazole and ≥ 64 μg/ml fluconazole) azole MIC values were tested using Checkerboard microdilution assay. The disk diffusion assay, the minimum fungicidal concentration and the time-kill assay were also performed in order to confirm the results of checkerboard microdilution assay. The MIC values of ITZ and FLZ of M. canis decreased in the presence of subinhibitory concentrations of HAL and PTZ, the latter being more effective with a greater increased susceptibility. Synergism was observed in all strains with high azole MICs (FICI < 0.5) and no synergism in the strains with low azole MICs. A fungicidal activity was observed after 48 h of incubation when ITZ and FLZ were tested in combination with HAL or PTZ. These results suggest that the drug efflux pumps are involved in the defense mechanisms to azole drugs in M. canis strains. The synergism might be related to an increased expression of efflux pump genes, eventually resulting in azole resistance phenomena. Complementary studies on M. canis resistance are advocated in order to investigate the molecular mechanisms of this phenomenon.
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Affiliation(s)
- Chioma Inyang 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
| | - Wafa Rhimi
- Dipartimento Di Medicina Veterinaria, Università Degli Studi "Aldo Moro", 70010, Valenzano (Bari), Italy.,Faculté Des Sciences de Bizerte, Université de Carthage, Zarzouna, Tunisia
| | - 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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39
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Łagowski D, Gnat S, Nowakiewicz A, Osińska M. Comparison of in vitro activities of 11 antifungal agents against Trichophyton verrucosum isolates associated with a variety hosts and geographical origin. Mycoses 2019; 63:294-301. [PMID: 31820493 DOI: 10.1111/myc.13042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 12/19/2022]
Abstract
The high prevalence of dermatophytosis in animals is usually associated with extra expenditure on prevention, diagnosis and long-term treatment. Humans are usually infected from animals, also from asymptomatic carriers, through direct contact or indirectly via fungus-bearing hair, scales and fomites. Despite the medical importance of Trichophyton verrucosum infections, there are limited in vitro data on the fungal susceptibility to antifungal drugs, including new-generation triazoles, imidazoles and allyloamines. The aim of the current study was to evaluate comprehensively the in vitro activity of 11 antifungal drugs against a large collection of T. verrucosum isolates obtained in Poland, Latvia, Lithuania and Slovakia from humans and animals using a microdilution assay. In vitro susceptibility testing of 11 antifungal drugs was performed according to the Clinical and Laboratory Standards Institute (CLSI) document M38. The MICs of clotrimazole, ciclopirox, enilconazole, miconazole, naftifine and terbinafine against all T. verrucosum isolates were below 1 μg/mL, whereas those of fluconazole, griseofulvin, itraconazole, ketoconazole and voriconazole were above 1 μg/mL. Ciclopirox was demonstrated to have superior activity against all strains in comparison with the other drugs, whereas fluconazole exerted the weakest in vitro effect and exhibited the highest MIC values. Our study has shown that drugs of different chemical origin have satisfactory antifungal activity and can be promising candidates for the treatment of T. verrucosum dermatophytosis. Moreover, no significant disparity in drug sensitivity between isolates obtained from different hosts and geographical regions have been demonstrated.
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Affiliation(s)
- Dominik Łagowski
- Sub-Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, University of Life Sciences, Lublin, Poland
| | - Sebastian Gnat
- Sub-Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, University of Life Sciences, Lublin, Poland
| | - Aneta Nowakiewicz
- Sub-Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, University of Life Sciences, Lublin, Poland
| | - Marcelina Osińska
- Sub-Department of Veterinary Microbiology, Faculty of Veterinary Medicine, Institute of Biological Bases of Animal Diseases, University of Life Sciences, Lublin, Poland
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40
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Saunte D, Hay R. Reply to the comment from Narang
et al
. on recalcitrant dermatophytosis. J Eur Acad Dermatol Venereol 2019; 33:e393-e394. [DOI: 10.1111/jdv.15685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- D.M.L Saunte
- Department of Dermatology Zealand University Hospital Roskilde Denmark
- Health Sciences Faculty University of Copenhagen Copenhagen Denmark
| | - R.J. Hay
- Department of Dermatology Kings College London London UK
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41
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Abastabar M, Jedi A, Guillot J, Ilkit M, Eidi S, Hedayati MT, Shokohi T, Daie Ghazvini R, Rezaei-Matehkolaei A, Katiraee F, Javidnia J, Ahmadi B, Badali H. In vitro activities of 15 antifungal drugs against a large collection of clinical isolates of Microsporum canis. Mycoses 2019; 62:1069-1078. [PMID: 31408550 DOI: 10.1111/myc.12986] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Microsporum canis is a zoophilic species, found to be the most frequently isolated species in animals. M. canis causes sporadic outbreaks of infections in humans, such as the one that occurred in Canada, where more than 1000 human cases were detected over an 8-year period. Despite the medical importance of M. canis infections, there are limited in vitro data on the antifungal susceptibility to antifungal drugs, including new generation triazoles and imidazoles. OBJECTIVE The aim of the current study was to comprehensively evaluate the in vitro activity of new azoles and comparator drugs against a large panel of M. canis isolates using a microdilution assay. METHODS The in vitro susceptibility to novel triazoles and imidazoles was compared to that of other antifungal drugs using a large collection of M. canis clinical isolates (n = 208) obtained from patients and animals with dermatophytosis in Iran, France and Turkey. RESULTS All isolates exhibited high susceptibility to the majority of the tested antifungal agents. However, luliconazole, lanoconazole and efinaconazole, as well as econazole, demonstrated superior activity against all strains in comparis on with the other drugs. CONCLUSION FDA-approved antifungal drugs, that is luliconazole, efinaconazole and lanoconazole, showed the highest antifungal activity and should be promising candidates for the treatment of dermatophytosis caused by M canis. However, their therapeutic effectiveness remains to be determined in clinical settings.
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Affiliation(s)
- Mahdi Abastabar
- Invasive Fungi Research Center, School of Medicine, Mazandaran University of Medical Sciences.,Department of Medical Mycology, Mazandaran University of Medical Sciences
| | - Ali Jedi
- Department of Medical Mycology, Mazandaran University of Medical Sciences.,Student Research Committee, Mazandaran University of Medical Sciences
| | - Jacques Guillot
- Department of Parasitology, Mycology, Dermatology, EA Dynamyc, UPEC, Ecole nationale vétérinaire d'Alfort
| | - Macit Ilkit
- Department of Medical Microbiology, Faculty of Medicine, University of Çukurova
| | - Samaneh Eidi
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad
| | - Mohammad Taghi Hedayati
- Invasive Fungi Research Center, School of Medicine, Mazandaran University of Medical Sciences.,Department of Medical Mycology, Mazandaran University of Medical Sciences
| | - Tahereh Shokohi
- Invasive Fungi Research Center, School of Medicine, Mazandaran University of Medical Sciences.,Department of Medical Mycology, Mazandaran University of Medical Sciences
| | - Roshanak Daie Ghazvini
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences
| | - Ali Rezaei-Matehkolaei
- Department of Medical Mycology, Faculty of Medicine/Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences
| | - Farzad Katiraee
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Javad Javidnia
- Student Research Committee, Mazandaran University of Medical Sciences
| | - Bahram Ahmadi
- Department of Medical Laboratory Sciences, Faculty of Paramedical, Bushehr University of Medical Sciences
| | - Hamid Badali
- Invasive Fungi Research Center, School of Medicine, Mazandaran University of Medical Sciences.,Department of Medical Mycology, Mazandaran University of Medical Sciences
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42
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Zheng H, Blechert O, Mei H, Ge L, Liu J, Tao Y, Li D, de Hoog GS, Liu W. Whole-genome resequencing of Trichophyton rubrum provides insights into population differentiation and drug resistance. Mycopathologia 2019; 185:103-112. [PMID: 31538279 DOI: 10.1007/s11046-019-00384-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 09/07/2019] [Indexed: 12/13/2022]
Abstract
Trichophyton rubrum (T. rubrum) is anthropophilic fungus and thus a very common cause of dermatophyte infections around the world. Infection of T. rubrum could result in conditions such as tinea capitis, tinea corporis, tinea inguinalis, tinea manus, tinea unguium, or tinea pedis. Because of this, the resistance of T. rubrum to antifungal therapies has drawn extensive research interest. However, the pathogenic characteristics of T. rubrum, such as site of infections, geographic location and host groups, have yet to be explored. In this study, the whole genome of 48 strains from different regions is resequenced and the population structure and association of single nucleotide polymorphism with resistance to six widely used antifungal drugs are analyzed. A total of 23,394 genomic variations are detected, which cover 2165 genes with only 15.14% of the variations located in exons. The population structure of T. rubrum is monomorphic, and genetic diversity is very low. Population structure analysis shows that the 48 sampled strains can be divided into two sub-populations. The gene TERG_08771 harboring the highest SNPs density is found to be associated with resistance to voriconazole. Although many proteins have yet to be identified and explored, association studies could still be useful to identify drug resistance or drug-susceptible loci, which would warrant further insightful investigations.
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Affiliation(s)
- Hailin Zheng
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, Jiangsu, People's Republic of China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu, China
| | - Oliver Blechert
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, Jiangsu, People's Republic of China
| | - Huan Mei
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, Jiangsu, People's Republic of China
| | - Liyu Ge
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, Jiangsu, People's Republic of China
| | - Jia Liu
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, Jiangsu, People's Republic of China
| | - Ye Tao
- Shanghai Biozeron Biotechnology Co., Ltd, Shanghai, China
| | - Dongmei Li
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, 20057, USA
| | - G S de Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
- Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
| | - Weida Liu
- Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, Jiangsu, People's Republic of China.
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, Jiangsu, China.
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43
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Dalla Lana DF, Carvalho ÂR, Lopes W, Vainstein MH, Guimarães LSP, Teixeira ML, de Oliveira LFS, Machado MM, de Andrade SF, Sá MM, Russo TVC, Silveira GP, Fuentefria AM. Structure-based design of δ-lactones for new antifungal drug development: susceptibility, mechanism of action, and toxicity. Folia Microbiol (Praha) 2019; 64:509-519. [PMID: 30734157 DOI: 10.1007/s12223-018-00675-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/26/2018] [Indexed: 01/26/2023]
Abstract
Dermatophytes are the etiological agents of cutaneous mycoses, including the prevalent nail infections and athlete's foot. Candida spp. are opportunistic and emerging pathogens, causing superficial to deeper infections related to high mortality rates. As a consequence of prolonged application of antifungal drugs, the treatment failures combined with multidrug-resistance have become a serious problem in clinical practice. Therefore, novel alternative antifungals are required urgently. δ-Lactones have attracted great interest owing to their wide range of biological activity. This article describes the antifungal activity of synthetic δ-lactones against yeasts of the genus Candida spp. and dermatophytes (through the broth microdilution method), discusses the pathways by which the compounds exert this action (toward the fungal cell wall and/or membrane), and evaluates the toxicity to human leukocytes and chorioallantoic membrane (by the hen's egg test-chorioallantoic membrane). Two of the compounds in the series presented broader spectrum of antifungal activity, including against resistant fungal species. The mechanism of action was related to damage in the fungal cell wall and membrane, with specific target action dependent on the type of substituent present in the δ-lactone structure. The damage in the fungal cell was corroborated by electron microscopy images, which evidenced lysed and completely altered cells after in vitro treatment with δ-lactones. Toxicity was dose dependent for the viability of human leukocytes, but none of the compounds was mutagenic, genotoxic, or membrane irritant when evaluated at higher concentrations than MIC. In this way, δ-lactones constitute a class with excellent perspectives regarding their potential applications as antifungals.
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Affiliation(s)
- Daiane F Dalla Lana
- Laboratory of Applied Mycology, Department of Analysis, Faculty of Pharmacy, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Ânderson R Carvalho
- Laboratory of Applied Mycology, Department of Analysis, Faculty of Pharmacy, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - William Lopes
- Department of Molecular Biology and Biotechnology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marilene H Vainstein
- Department of Molecular Biology and Biotechnology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luciano S P Guimarães
- Biostatistics Unit, Research Group and Post-graduation, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Mário L Teixeira
- Laboratory of Biochemistry and Toxicology, Instituto Federal de Santa Catarina, Concordia, SC, Brazil
| | - Luis F S de Oliveira
- Center for Studies in Biochemistry, Immunology, and Toxicology, Universidade Federal do Pampa, Uruguaiana, RS, Brazil
| | - Michel M Machado
- Center for Studies in Biochemistry, Immunology, and Toxicology, Universidade Federal do Pampa, Uruguaiana, RS, Brazil
| | - Saulo F de Andrade
- Department of Raw Materials Production, Faculty of Pharmacy, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marcus M Sá
- Department of Chemistry, Universidade Federal de Santa Catarina, Florianopolis, SC, Brazil
| | - Theo V C Russo
- Department of Chemistry, Universidade Federal de Santa Catarina, Florianopolis, SC, Brazil
| | - Gustavo P Silveira
- Department of Organic Chemistry, Institute of Chemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alexandre M Fuentefria
- Laboratory of Applied Mycology, Department of Analysis, Faculty of Pharmacy, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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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: 40] [Impact Index Per Article: 8.0] [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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45
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Correlation of In Vitro Susceptibility Based on MICs and Squalene Epoxidase Mutations with Clinical Response to Terbinafine in Patients with Tinea Corporis/Cruris. Antimicrob Agents Chemother 2018; 62:AAC.01038-18. [PMID: 30275090 DOI: 10.1128/aac.01038-18] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 09/22/2018] [Indexed: 11/20/2022] Open
Abstract
Recalcitrant dermatophytoses are on the rise in India. High MICs of terbinafine (TRB) and squalene epoxidase (SQLE) gene mutations conferring resistance in Trichophyton spp. have been recently documented. However, studies correlating laboratory data with clinical response to TRB in tinea corporis/cruris are lacking. For this study, we investigated the clinicomycological profile of 85 tinea corporis/cruris patients and performed antifungal susceptibility testing by CLSI microbroth dilution and SQLE mutation analysis of the isolates obtained and correlated these with the responses to TRB. Patients confirmed by potassium hydroxide (KOH) mounting of skin scrapings were started on TRB at 250 mg once a day (OD). If >50% clinical clearance was achieved by 3 weeks, the same dose was continued (group 1). If response was <50%, the dose was increased to 250 mg twice a day (BD) (group 2). If the response still remained below 50% after 3 weeks of BD, the patients were treated with itraconazole (ITR; group 3). Overall, skin scrapings from 64 (75.3%) patients yielded growth on culture. Strikingly, all isolates were confirmed to be Trichophyton interdigitale isolates by internal transcribed spacer (ITS) sequencing. Thirty-nine (61%) of the isolates had TRB MICs of ≥1 µg/ml. Complete follow-up data were available for 30 culture-positive patients. A highly significant difference in modal MICs to TRB among the three treatment response groups was noted (P = 0.009). Interestingly, 8 of the 9 patients in group 3 harbored isolates exhibiting elevated TRB MICs (8 to 32 µg/ml) and SQLE mutations. The odds of achieving cure with TRB MIC < 1 µg/ml strains were 2.5 times the odds of achieving cure with the strain exhibiting MIC ≥1 µg/ml.
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46
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Liu X, Liu J, Jiang T, Zhang L, Huang Y, Wan J, Song G, Lin H, Shen Z, Tang C. Analysis of chemical composition and in vitro antidermatophyte activity of ethanol extracts of Dryopteris fragrans (L.) Schott. JOURNAL OF ETHNOPHARMACOLOGY 2018; 226:36-43. [PMID: 30063973 DOI: 10.1016/j.jep.2018.07.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 07/23/2018] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Dryopteris fragrans (L.) Schott is a deciduous perennial herb, which has been used traditionally for treatment of ringworm infections and others skin diseases in the north of China. AIM OF THE STUDY To characterize the chemical composition, evaluate the antifungal activity and explore possible mechanisms about action of ethanol extracts of D. fragrans. MATERIALS AND METHODS The chemical components in the ethanol extracts of D. fragrans were detected by high-performance liquid chromatography coupled with electrospray ionization and quadruple time-of-flight mass spectrometry (HPLC-ESI-QTOF-MS/MS). The minimal inhibitory concentrations (MIC) and minimal fungicidal concentrations (MFC) of the ethanol extracts of D. fragrans were determined by the Clinical and Laboratory Standards Institute (CLSI) M38-A2 method against 62 isolates of dermatophytes. The kinetics of fungal kill, synergy testing by checkerboard dilution and quantitation of sterol by ultra-performance liquid chromatography (UPLC) on Trichophyton rubrum and Trichophyton mentagrophytes were also investigated. RESULTS Fourteen derivatives of phloroglucinol were identified in the ethanol extracts of D. fragrans. The MIC of the ethanol extracts of D. fragrans ranged from 0.059 to 3.780 mg/mL while MFC ranged from 0.118 to 3.780 mg/mL. The ethanol extracts of D. fragrans exerted fungicidal activity after 12 h of incubation against Trichophyton rubrum while it required 36 h of incubation against Trichophyton mentagrophytes at concentrations of 8 × MIC. In synergy testing, the interaction between miconazole (MCZ) and terbinafine (TBF) with the ethanol extracts of D. fragrans proved to be indifferent by testing fractional inhibitory concentration (FIC) values. Sterol in samples of fungal cells treated with the ethanol extracts of D. fragrans was significantly reduced. CONCLUSIONS The ethanol extracts of D. fragrans had antifungal and fungicidal activity against dermatophytes and was likely a strain-dependent fungicidal agent. Interaction between drugs was indifferent on tested isolates. The inhibition of ergosterol biosynthesis was one of the antifungal mechanisms of the ethanol extracts of D. fragrans. These results showed that the ethanol extracts of D. fragrans could be explored for promising antifungal drugs. Dozens of phloroglucinol derivatives may contribute to high antifungal activity of the ethanol extracts of D. fragrans.
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Affiliation(s)
- Xueping Liu
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China
| | - Jiayuan Liu
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China
| | - Tao Jiang
- Laboratory Animal Center, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China
| | - Lili Zhang
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China
| | - Yixi Huang
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China
| | - Jiangfan Wan
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China
| | - Guoqiang Song
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China
| | - Haoqi Lin
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China
| | - Zhibin Shen
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China.
| | - Chunping Tang
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China; Guangdong Provincial Engineering Center of Topical Precise Drug Delivery System, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, China.
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47
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Yin S, Xie X, Li M, Zhou X, Wei L, Chen Z, Chen J, Lu C, de Hoog S, Lai W, Feng P. Prevalence of low inflammatory tinea genitalis in southern China. Mycoses 2018; 62:284-290. [PMID: 30307067 DOI: 10.1111/myc.12859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/27/2018] [Accepted: 10/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Emergence of highly inflammatory genital dermatophyte infections has been reported from Southeast Asia. In view of this, knowledge of the non-outbreak fungal flora of the genitals is required as a baseline study. OBJECTIVES We present our 12-year experience in a tertiary clinic with the diagnosis of scrotal fungal infections. METHODS A retrospective review was performed of patients with a diagnosis of scrotal fungal infections proven by direct microscopy and culture. Clinical, mycological and treatment data were collected. RESULTS In total, 35 male patients were identified, of which 27 concerned dermatophyte infections and eight were yeasts. Nannizzia gypsea was the most common agent (48.6%), presenting as thick pseudomembraneous lesions limited to the scrotum. Trichophyton rubrum (22.9%) and Epidermophyton floccosum (5.7%) mainly presented erythematous, dry and scaly lesions and involving more sites besides the scrotum. Candida albicans (n = 3), C. glabrata (n = 2), C. guilliermondii (n = 1) and Trichosporon asteroides (n = 1), presented various lesions. Sports, sweating and concurrent tineas are hypothesised as predisposing factors. CONCLUSIONS The prevalent causative agent of scrotum infections is N. gypsea, but wide species diversity is observed. All infections show mild skin inflammation. It is suggested that this genital fungal flora represents the current situation prior to clonal dermatophyte outbreaks.
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Affiliation(s)
- Songchao Yin
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyuan Xie
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meirong Li
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xin Zhou
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ling Wei
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhirui Chen
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jian Chen
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chun Lu
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sybren de Hoog
- Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands.,Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Wei Lai
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Peiying Feng
- Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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48
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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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49
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You Z, Ran X, Dai Y, Ran Y. Clioquinol, an alternative antimicrobial agent against common pathogenic microbe. J Mycol Med 2018; 28:492-501. [DOI: 10.1016/j.mycmed.2018.03.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/17/2018] [Accepted: 03/18/2018] [Indexed: 12/11/2022]
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50
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Danielli LJ, Pippi B, Duarte JA, Maciel AJ, Lopes W, Machado MM, Oliveira LFS, Vainstein MH, Teixeira ML, Bordignon SAL, Fuentefria AM, Apel MA. Antifungal mechanism of action of Schinus lentiscifolius Marchand essential oil and its synergistic effect in vitro with terbinafine and ciclopirox against dermatophytes. ACTA ACUST UNITED AC 2018; 70:1216-1227. [PMID: 29956331 DOI: 10.1111/jphp.12949] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/28/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the antifungal, antichemotactic and antioxidant activities of Schinus lentiscifolius essential oil, as well as its combined effect with terbinafine and ciclopirox, against dermatophytes. METHODS Essential oil was analysed by GC-MS. The antifungal activity and the mechanism of action were determined by broth microdilution, sorbitol and ergosterol assays, as well as scanning electron microscopy. The checkerboard method was used for evaluating the interactions with commercial antifungal agents. The antioxidant and antichemotactic activities were measured using the DPPH and the modified Boyden chamber methods, respectively. KEY FINDINGS Chemical analysis revealed the presence of 33 compounds, the primary ones being γ-eudesmol (12.8%) and elemol (10.5%). The oil exhibited 97.4% of antichemotactic activity and 37.9% of antioxidant activity. Antifungal screening showed effect against dermatophytes with minimum inhibitory concentration values of 125 and 250 μg/ml. Regarding the mechanisms of action, the assays showed that the oil can act on the fungal cell wall and membrane. Synergistic interactions were observed using the combination with antifungals, primarily terbinafine. CONCLUSIONS Schinus lentiscifolius essential oil acted as a chemosensitizer of the fungal cell to the drug, resulting in an improvement in the antifungal effect. Therefore, this combination can be considered as an alternative for the topical treatment of dermatophytosis.
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Affiliation(s)
- Letícia J Danielli
- Pharmaceutical Sciences Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Pippi
- Agricultural and Environmental Microbiology Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jonathaline A Duarte
- Pharmaceutical Sciences Graduate Program, Federal University of Pampa, Uruguaiana, Brazil
| | - Ana J Maciel
- Pharmaceutical Sciences Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - William Lopes
- Biotechnology Center, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Michel M Machado
- Pharmaceutical Sciences Graduate Program, Federal University of Pampa, Uruguaiana, Brazil
| | - Luis Flávio S Oliveira
- Pharmaceutical Sciences Graduate Program, Federal University of Pampa, Uruguaiana, Brazil
| | - Marilene H Vainstein
- Biotechnology Center, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mário L Teixeira
- Laboratory of Biochemistry and Toxicology, Institute Federal of Santa Catarina, Concórdia, Brazil
| | - Sérgio A L Bordignon
- Environmental Impact Assessment Graduate Program, La Salle University Center, Canoas, Brazil
| | - Alexandre M Fuentefria
- Pharmaceutical Sciences Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Agricultural and Environmental Microbiology Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Miriam A Apel
- Pharmaceutical Sciences Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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