Ricard-Blum S, Hartmann D J, Esterre P
Institut Pasteur de Lyon France.
Eur J Clin Invest. 1998 Sep;28(9):748-54. doi: 10.1046/j.1365-2362.1998.00335.x.
Chromoblastomycosis is a fungal disease leading to a granulomatous reaction associated with dermal fibrosis.
In an attempt to elucidate the mechanisms leading to improvement in the cutaneous lesions after treatment with terbinafine, a new antifungal drug, we analysed collagen content and cross-linking before and at the end of the treatment. The turnover of extracellular matrix was monitored for 1 year by following up serum and urinary metabolites.
The serum levels of type III collagen and its N-terminal propeptide were correlated with the lesion size (P < 0.035) after 4 and 12 months of treatment respectively. After 4 months of treatment, urinary pyridinoline was higher (P = 0.04) in patients whose lesion size was reduced by more than 50% and serum hyaluronan was lower in patients who had lesions active for less than 5 years (P < 0.05). The treatment increased pyridinoline and pentosidine cross-links in the lesions but significantly reduced the collagen content (P = 0.05).
This is the first demonstration that, in addition to its fungicidal activity, terbinafine acts in vivo as an antifibrotic drug.
着色芽生菌病是一种导致与皮肤纤维化相关的肉芽肿反应的真菌病。
为了阐明使用新型抗真菌药物特比萘芬治疗后皮肤病变改善的机制，我们分析了治疗前和治疗结束时的胶原蛋白含量及交联情况。通过随访血清和尿液代谢产物，对细胞外基质的周转进行了1年的监测。
治疗4个月和12个月后，血清III型胶原蛋白及其N端前肽水平分别与病变大小相关（P < 0.035）。治疗4个月后，病变大小缩小超过50%的患者尿吡啶啉水平较高（P = 0.04），病变活动少于5年的患者血清透明质酸水平较低（P < 0.05）。治疗增加了病变中的吡啶啉和戊糖苷交联，但显著降低了胶原蛋白含量（P = 0.05）。
这是首次证明，除了其杀菌活性外，特比萘芬在体内还作为一种抗纤维化药物发挥作用。
