Yu Zhao, Liu Zhihao, Qian Jiaojiao, Qian Yuanyuan
Department of Emergency, Haining Branch, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Department of Respiratory and Critical Care, Haining Branch, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
AMB Express. 2025 Jan 30;15(1):19. doi: 10.1186/s13568-025-01827-3.
Cryptococcal pneumonia is a severe fungal infection of the respiratory system, predominantly caused by Cryptococcus neoformans. Its incidence is increasing, driven by evolving pathogen dynamics and heightened susceptibility among patient populations. This investigation aimed to assess the combined therapeutic efficacy of Fluconazole and Amphotericin B for cryptococcal pneumonia and to explore the roles of miR-15b and TGF-β1 in modulating treatment response. Twenty-eight patients diagnosed with cryptococcal pneumonia were randomly allocated to receive either Amphotericin B monotherapy (control group) or a combination of Amphotericin B and Fluconazole (observation group) over a 14-day period. Key respiratory function indices-forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratios-were measured pre- and post-treatment, alongside levels of procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), miR-15b, and TGF-β1. Results demonstrated marked improvements in pulmonary function within the observation group, with significantly higher FEV1, FVC, and FEV1/FVC values than those in the control group (P < 0.05). Additionally, the observation group exhibited greater reductions in PCT and sTREM-1, coupled with notable elevations in miR-15b and TGF-β1 levels. The combination therapy achieved a total response rate of 92.86%, significantly surpassing the control's 57.14% efficacy (P < 0.05). These findings indicate that Fluconazole combined with Amphotericin B not only enhances clinical efficacy by mitigating inflammation but also supports lung function recovery with a favourable safety profile, highlighting its utility in managing cryptococcal pneumonia effectively.
隐球菌性肺炎是一种严重的呼吸系统真菌感染，主要由新型隐球菌引起。由于病原体动态变化和患者群体易感性增加，其发病率正在上升。本研究旨在评估氟康唑和两性霉素B联合治疗隐球菌性肺炎的疗效，并探讨miR-15b和TGF-β1在调节治疗反应中的作用。28例诊断为隐球菌性肺炎的患者被随机分配，在14天内接受两性霉素B单药治疗（对照组）或两性霉素B与氟康唑联合治疗（观察组）。在治疗前后测量关键呼吸功能指标——一秒用力呼气量（FEV1）、用力肺活量（FVC）和FEV1/FVC比值，同时检测降钙素原（PCT）、髓系细胞表面可溶性触发受体-1（sTREM-1）、miR-15b和TGF-β1的水平。结果显示观察组肺功能有显著改善，FEV1、FVC和FEV1/FVC值显著高于对照组（P < 0.05）。此外，观察组的PCT和sTREM-1降低幅度更大，同时miR-15b和TGF-β1水平显著升高。联合治疗的总有效率为92.86%，显著超过对照组的57.14%（P < 0.05）。这些发现表明，氟康唑与两性霉素B联合使用不仅通过减轻炎症提高临床疗效，还能支持肺功能恢复，且安全性良好，突出了其在有效治疗隐球菌性肺炎方面的实用性。
