通过对烯丙康唑、艾沙康唑、泊沙康唑和特比萘芬进行体外和体内评估,探讨野生型和非野生型申克孢子丝菌所致孢子丝菌病的治疗替代方案。

Therapeutic alternatives for sporotrichosis induced by wild-type and non-wild-type Sporothrix schenckii through in vitro and in vivo assessment of enilconazole, isavuconazole, posaconazole, and terbinafine.

作者信息

Aroonvuthiphong Vasurom, Bangphoomi Norasuthi

机构信息

Veterinary Biomedical Science Program, Faculty of Veterinary Science, Mahidol University, Salaya, Thailand.

Department of Pre-clinic and Applied Animal Science, Faculty of Veterinary Science, Mahidol University, Salaya, Thailand.

出版信息

Sci Rep. 2025 Jan 25;15(1):3230. doi: 10.1038/s41598-025-87711-3.

Abstract

This study explores the effectiveness of various antifungal drugs in treating sporotrichosis caused by Sporothrix schenckii, especially in non-wild-type (non-WT) strains. The drugs tested include enilconazole (ENIL), isavuconazole (ISA), posaconazole (POS), terbinafine (TER), and itraconazole (ITC). The study involved in vitro and in vivo tests on 10 WT isolates and eight ITC non-WT isolates. Two isolates were assessed using time-kill assays, checkerboard assays, and Galleria mellonella infection models. In vitro studies have shown that all of these drugs were more effective than or equal to ITC against WT and non-WT isolates. No ITC resistance was observed with other azoles. All drugs inhibited fungal growth of WT and non-WT strains within 24 h at all incubations. ENIL and TER showed fungicidal effect against types at over 2x minimum inhibitory concentrations with no regrowth. POS was fungicidal against WT at high concentrations but not against non-WT. ISA was only fungicidal for non-WT. ITC did not exhibit any fungicidal activity. In checkerboard experiments, the combination of POS or ISA with TER showed enhanced activity against WT and non-WT strains, surpassing the combination of ITC with TER. In vivo model experiments demonstrated significantly reduced mortality rates with ENIL, POS, and TER against WT and with ENIL, ISA, POS, and TER against non-WT. The study concludes that monotherapy with ENIL, ISA, POS, and TER, and combinations of POS/TER or ISA/TER, show promise as effective antifungal treatments against S. schenckii, including ITC-non-WT isolates.

摘要

本研究探讨了各种抗真菌药物治疗申克孢子丝菌引起的孢子丝菌病的有效性,尤其是对非野生型(非WT)菌株的疗效。所测试的药物包括烯丙康唑(ENIL)、艾沙康唑(ISA)、泊沙康唑(POS)、特比萘芬(TER)和伊曲康唑(ITC)。该研究对10株野生型菌株和8株伊曲康唑非野生型菌株进行了体外和体内试验。使用时间杀菌试验、棋盘试验和大蜡螟感染模型对其中2株菌株进行了评估。体外研究表明,所有这些药物对野生型和非野生型菌株的疗效均优于或等同于伊曲康唑。未观察到其他唑类药物存在伊曲康唑耐药性。所有药物在所有培养条件下均能在24小时内抑制野生型和非野生型菌株的真菌生长。烯丙康唑和特比萘芬在超过2倍最低抑菌浓度时对各类型菌株均显示出杀菌作用,且无再生长现象。泊沙康唑在高浓度时对野生型菌株具有杀菌作用,但对非野生型菌株无杀菌作用。艾沙康唑仅对非野生型菌株具有杀菌作用。伊曲康唑未表现出任何杀菌活性。在棋盘试验中,泊沙康唑或艾沙康唑与特比萘芬联合使用对野生型和非野生型菌株均显示出增强的活性,超过了伊曲康唑与特比萘芬联合使用的效果。体内模型实验表明,烯丙康唑、泊沙康唑和特比萘芬对野生型菌株以及烯丙康唑、艾沙康唑、泊沙康唑和特比萘芬对非野生型菌株的治疗均显著降低了死亡率。该研究得出结论,烯丙康唑、艾沙康唑、泊沙康唑和特比萘芬单药治疗以及泊沙康唑/特比萘芬或艾沙康唑/特比萘芬联合治疗有望成为治疗申克孢子丝菌的有效抗真菌疗法,包括对伊曲康唑非野生型菌株。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f631/11762301/ba5ecbedd606/41598_2025_87711_Fig1_HTML.jpg

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