Photodynamic inactivation by hypericin-P123 on azole-resistant isolates of the Trichophyton rubrum complex as planktonic cells and biofilm.

INTRODUCTION: The Trichophyton rubrum complex comprises the majority of dermatophyte fungi (DM) responsible for chronic cases of onychomycosis, which is treated with oral or topical antifungals. However, owing to antifungal resistance, alternative therapies, such as photodynamic therapy (PDT), are needed. This study investigated the frequency of the T. rubrum species complex in onychomycosis cases in the northwestern region of Paraná state, Brazil, and evaluated the efficacy of (PDT) using P123-encapsulated hypericin (Hyp-P123) on clinical isolates of T. rubrum in the planktonic cell and biofilm forms. MATERIAL AND METHODS: The frequency of the T. rubrum complex in onychomycosis cases from 2017 to 2021 was evaluated through a data survey of records from the Laboratory of Medical Mycology (LEPAC) of the State University of Maringa (UEM). To determine the effect of PDT-Hyp-P123 on planktonic cells of T. rubrum isolates, 1 × 105 conidia/mL were treated with ten different concentrations of Hyp-P123 and then irradiated with 37.8 J/cm2. Antibiofilm activity of PDT-Hyp-P123 was tested against T. rubrum biofilm in the adhesion phase (3 h), evaluated 72 h after irradiation (37.8 J/cm2), and the mature biofilm (72 h), evaluated immediately after irradiation. In this context, three different parameters were evaluated: cell viability, metabolic activity and total biomass. RESULTS: The T. rubrum species complex was the most frequently isolated DM in onychomycosis cases (approximately 80 %). A significant reduction in fungal growth was observed for 75 % of the clinical isolates tested with a concentration from 0.19 µmol/L Hyp-P123, and 56.25 % had complete inhibition of fungal growth (fungicidal action); while all isolates were azole-resistant. The biofilm of T. rubrum isolates (TR0022 and TR0870) was inactivated in both the adhesion phase and the mature biofilm. CONCLUSION: PDT-Hyp-P123 had antifungal and antibiofilm activity on T. rubrum, which is an important dermatophyte responsible for onychomycosis cases.

The chemistry of Vernonanthura nudiflora (Less.) H. Rob. flowers and its antimicrobial activities.

Twenty-one known specialised metabolites were isolated from the flowers of Vernonanthura nudiflora (Less.) H. Rob., the structures of the compounds were established based on 1 D and 2 D NMR spectroscopic experiments. Others 28 compounds were putatively identified using the dereplication technique by UHPLC-HRMS/MS. Twenty-three of the compounds are being reported for the first time in this species. The mixture of sesquiterpene lactones piptocarphins A and B (17 + 18), and the flavone velutin (14) were tested against several microorganisms and showed promising activity against Mycobacterium tuberculosis with MIC of 15.6 µg/mL and 31.2 µg/mL, respectively. Furthermore, 17 + 18 showed greater cytotoxicity against VERO cells (IC50 = 7.0 ± 1.73) compared to compound 14 (IC50 85.0 ± 10.6 µg/mL). These findings reveal the feasibility of using the UHPLC-ESI-HRMS/MS-based dereplication strategy in complex fractions to identify specialised metabolites, moreover to V. nudiflora flowers being a source of compounds with antimycobacterial potential.

Nanoencapsulated hypericin in P-123 associated with photodynamic therapy for the treatment of dermatophytosis.

The antifungal application of photodynamic therapy (PDT) has been widely explored. According to superficial nature of tinea capitis and the facility of application of light sources, the use of nanoencapsulated hypericin in P-123 associated with PDT (P123-Hy-PDT) has been a poweful tool to treat this pathology. Thus, the aim of this study was to evaluate the efficiency of P123-Hy-PDT against planktonic cells and in a murine model of dermatophytosis caused by Microsporum canis. In vitro antifungal susceptibility and in vivo efficiency tests were performed, including a skin toxicity assay, analysis of clinical signs by evaluating score, and photoacoustic spectroscopy. In addition, tissue analyses by histopathology and levels of pro-inflammatory cytokines, such as quantitative and qualitative antifungal assays, were employed. The in vitro assays demonstrated antifungal susceptibility with 6.25 and 12.5 µmol/L P123-Hy-PDI; these experiments are the first that have used this treatment of animals. P123-Hyp-mediated PDT showed neither skin nor biochemical alteration in vivo; it was safe for dermatophytosis treatment. Additionally, the treatment revealed rapid improvement in clinical signs at the site of infection after only three treatment sessions, with a clinical score confirmed by photoacoustic spectroscopy. The mycological reduction occurred after six treatment sessions, with a statistically significant decrease compared with untreated infected animals. These findings showed that P123-Hy-PDT restored tissue damage caused by infection, a phenomenon confirmed by histopathological analysis and proinflammatory cytokine levels. Our results reveal for the first time that P123-Hy-PDT is a promising treatment for tinea capitis and tinea corporis caused by M. canis, because it showed rapid clinical improvement and mycological reduction without causing toxicity.

Propolis for the Treatment of Onychomycosis.

Onychomycosis is a fungal nail infection, considered as a public health problem because it is contagious and it interferes with the quality of life. It has long and difficult treatment, with many side effects and high cost. Propolis extract (PE) is a potential alternative to conventional antifungal agents because it has low cost, accessibility, and low toxicity. Herein, we report the favorable response of PE in onychomycosis in three elderly patients.