Photodynamic therapy combined with antifungal drugs against chromoblastomycosis and the effect of ALA-PDT on Fonsecaea in vitro

Chromoblastomycosis is a chronic skin and subcutaneous fungal infection caused by dematiaceous fungi and is associated with low cure and high relapse rates. In southern China, Fonsecaea monophora and Fonsecaea pedrosoi are the main causative agents. We treated 5 refractory and complex cases of chrom...

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Published in:PLoS neglected tropical diseases 2019-10, Vol.13 (10), p.e0007849-e0007849
Main Authors: Hu, Yongxuan, Qi, Xinyu, Sun, Hengbiao, Lu, Yan, Hu, Yanqing, Chen, Xuyang, Liu, Kangxing, Yang, Yemei, Mao, Zuhao, Wu, Zhong, Zhou, Xianyi
Format: Article
Language:English
Subjects:
Acids
Aminolevulinic acid
Aminolevulinic Acid - therapeutic use
Antifungal agents
Antifungal Agents - therapeutic use
Ascomycota - drug effects
Ascomycota - radiation effects
Biology and Life Sciences
Cell walls
China
Chromoblastomycosis - drug therapy
Chromoblastomycosis - pathology
Chromoblastomycosis - radiotherapy
Chromomycosis
Chronic infection
Combination drug therapy
Dermatology
Disease
DNA, Fungal
Drugs
Family medical history
Female
Fungal infections
Fungi
Fungicides
Health aspects
Hospitals
Humans
Infection
Itraconazole
Itraconazole - therapeutic use
Lesions
Male
Medicine and Health Sciences
Microbial Sensitivity Tests
Middle Aged
Mycoses
Pathogens
Photochemotherapy
Photochemotherapy - methods
Photodynamic therapy
Physical Sciences
Reactive oxygen species
Skin
Skin - metabolism
Terbinafine
Terbinafine - therapeutic use
Therapy
Tropical diseases
Voriconazole
Voriconazole - therapeutic use
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Qi, Xinyu
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Hu, Yanqing
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Yang, Yemei
Mao, Zuhao
Wu, Zhong
Zhou, Xianyi
description Chromoblastomycosis is a chronic skin and subcutaneous fungal infection caused by dematiaceous fungi and is associated with low cure and high relapse rates. In southern China, Fonsecaea monophora and Fonsecaea pedrosoi are the main causative agents. We treated 5 refractory and complex cases of chromoblastomycosis with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) combined with oral antifungal drugs. The lesions improved after 4 to 9 sessions of ALA-PDT treatment at an interval of one or two weeks, and in some cases, mycological testing results became negative. The isolates were assayed for susceptibility to antifungal drugs and ALA-PDT in vitro, revealing sensitivity to terbinafine, itraconazole and voriconazole, with ALA-PDT altering the cell wall and increasing reactive oxygen species production. These results provide the basis for the development of a new therapeutic approach, and ALA-PDT combined with oral antifungal drugs constitutes a promising alternative method for the treatment of refractory and complex cases of chromoblastomycosis.
doi_str_mv 10.1371/journal.pntd.0007849
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In southern China, Fonsecaea monophora and Fonsecaea pedrosoi are the main causative agents. We treated 5 refractory and complex cases of chromoblastomycosis with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) combined with oral antifungal drugs. The lesions improved after 4 to 9 sessions of ALA-PDT treatment at an interval of one or two weeks, and in some cases, mycological testing results became negative. The isolates were assayed for susceptibility to antifungal drugs and ALA-PDT in vitro, revealing sensitivity to terbinafine, itraconazole and voriconazole, with ALA-PDT altering the cell wall and increasing reactive oxygen species production. 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ispartof PLoS neglected tropical diseases, 2019-10, Vol.13 (10), p.e0007849-e0007849
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language eng
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subjects Acids
Aminolevulinic acid
Aminolevulinic Acid - therapeutic use
Antifungal agents
Antifungal Agents - therapeutic use
Ascomycota - drug effects
Ascomycota - radiation effects
Biology and Life Sciences
Cell walls
China
Chromoblastomycosis - drug therapy
Chromoblastomycosis - pathology
Chromoblastomycosis - radiotherapy
Chromomycosis
Chronic infection
Combination drug therapy
Dermatology
Disease
DNA, Fungal
Drugs
Family medical history
Female
Fungal infections
Fungi
Fungicides
Health aspects
Hospitals
Humans
Infection
Itraconazole
Itraconazole - therapeutic use
Lesions
Male
Medicine and Health Sciences
Microbial Sensitivity Tests
Middle Aged
Mycoses
Pathogens
Photochemotherapy
Photochemotherapy - methods
Photodynamic therapy
Physical Sciences
Reactive oxygen species
Skin
Skin - metabolism
Terbinafine
Terbinafine - therapeutic use
Therapy
Tropical diseases
Voriconazole
Voriconazole - therapeutic use
title Photodynamic therapy combined with antifungal drugs against chromoblastomycosis and the effect of ALA-PDT on Fonsecaea in vitro
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T00%3A58%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Photodynamic%20therapy%20combined%20with%20antifungal%20drugs%20against%20chromoblastomycosis%20and%20the%20effect%20of%20ALA-PDT%20on%20Fonsecaea%20in%20vitro&rft.jtitle=PLoS%20neglected%20tropical%20diseases&rft.au=Hu,%20Yongxuan&rft.date=2019-10-01&rft.volume=13&rft.issue=10&rft.spage=e0007849&rft.epage=e0007849&rft.pages=e0007849-e0007849&rft.issn=1935-2735&rft.eissn=1935-2735&rft_id=info:doi/10.1371/journal.pntd.0007849&rft_dat=%3Cgale_plos_%3EA607647202%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c624t-e0940ac9ddfd5e708aa2257d362b676eed1a202f4b174f6990c60490826cb4ac3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2314542035&rft_id=info:pmid/31671098&rft_galeid=A607647202&rfr_iscdi=true