Figures
Figure 1
Morphological and molecular analysis. A ) All strains became visible, presenting dark pigment on Sabouraud dextrose agar. B ) Polymerase chain reaction products amplified with CL1 and CL2A primers based on the calmodulin gene sequence. Lane 1: DNA molecular weight marker; Lanes 2-6: polymerase chain reaction products from the Sporothrix isolates. Sequence searches in GenBank revealed that all isolates were 100% similar to those previously published for S. globosa strains. C , D , E , F , G ) The effect of photodynamic therapy on viability of S. globosa conidia; residual antimicrobial activities (per mL) from the L-M-, L + M-, and L-M+ groups were similar, but significantly lower in the L + M+ group. Numbers 1 and 2 indicate significant difference (p < 0.01) for each strain.
Figure 1
Figure 2
Possible synergistic effect between itraconazole and PDT-MB. A , B ) Morphology of the yeast phase of Sporothrix globosa showing clinical isolates under a scanning electron microscope. A ) Photodynamic therapy without methylene blue does not cause morphological changes. B ) Photodynamic therapy using methylene blue causes the conidia of Sporothrix globosa to shrink and elongate. C ) PDT-MB acts together with itraconazole to kill Sporothrix globosa .
Figure 2
Figure 3
Lesion sizes in infected mouse models in response to various antifungal treatments: (A ) sodium chloride control solution; (B ) PDT group; (C ) itraconazole group; and (D ) PDT+ itraconazole group. Peak size was achieved on Day 8 (B -D ), but not for control mice for which a peak was achieved on Day 20 (A ). The lesions in all groups except control group eventually began to shrink. The PDT+ itraconazole group demonstrated a significant reduction compared to the PDT and itraconazole groups on Day 20 (E ) and Day 30 (F ). *p < 0.05 and **p < 0.01 indicates statistical significance regarding the times of treatment; NS: not significant.
Figure 3
Figure 4
Histopathology of skin tissues from infected mice before treatment (A ) and treated with sodium chloride solution (B , D ), PDT (C ), and PDT + itraconazole (E ). The area of concentrated inflammatory cells in the control group (A ) significantly increased compared with the PDT (B ), itraconazole (C ), and itraconazole + PDT (E ) groups. F ) Among all the groups, the PDT + itraconazole group showed the most significant decrease in percentage area of inflammatory cells (p < 0.01).
Figure 4
Authors
1 China-Japan Union Hospital of Jilin University, Changchun, Jilin
2 Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
Background Sporothrix schenckii strains are the aetiological agents of sporotrichosis, which is endemic in China. The most common clinical manifestation of sporotrichosis is cutaneous and subcutaneous nodular lesions with lymphangitis involvement. Currently, antifungal therapy is commonly used to treat sporotrichosis , however, drug resistance and complications are the major concerns, especially in patients who have asymptomatic liver injury or existing liver disorders, children, and pregnant women.