Vaccines for Children: List By Age, Benefits, Safety
Bone Loss Drugs Can Help Azoles Fight Fungal Infections
Human skin, hair and nails are all vulnerable to fungal infections. While these infections are usually not serious, they're difficult to fully resolve and often recur after treatment -- sometimes for years. They're also often resistant to treatments, including a common class of antifungals called azoles.
A study published this week in mSphere points to a new way to boost the efficacy of azoles in treating those infections -- combining them with commonly available drugs called bisphosphonates, usually used to treat osteoporosis. Previous work by the same research group has shown that adding bisphosphonates to azoles can effectively treat yeast infections from Candida and Cryptococcus species. The new study extends that finding to dermatophytes, which cause superficial infections.
The study suggests that bisphosphonates could be repurposed to use with azole antifungals, which are relatively nontoxic, and that the combination could be readily tested in clinical studies.
"There aren't many good antifungal drugs around, and the fungus will always develop resistance no matter how you treat them," said senior author Dee Carter, a mycologist at the University of New South Wales, Australia. "For what we're proposing, to use 2 drugs at the same time, that resistance is much less likely."
Carter says she was only a little surprised to see the synergistic effect in dermatophytes. This research project began years ago, she says, when her group conducted a series of genomic analyses on the response of pathogenic yeasts to drug treatment. That study led them to a genetic pathway that is "upstream" of the pathway targeted by azoles, and is instead targeted by bisphosphonates. "That's often a good way to get drugs to work, is to target processes that are interlinked like that," Carter said.
In the lab, Carter and her team tested 3 commonly available bisphosphonates (risedronate, alendronate and zoledronate) in combination with 3 commonly available azole antifungals (fluconazole, itraconazole and ketoconazole). They tested these against clinical isolates from a diverse range of dermatophyte species that cause superficial infections. The combination of zoledronate and ketoconazole proved particularly effective against 8 of the 9 tested species. It also prevented the development of resistance.
Aidan Kane, mycologist, lead author of the study and a Ph.D. Student in Carter's lab, used fluorescence microscopy and other methods to show that the drug combination worked by weakening the cell membrane enough that the fungus could not survive. Beyond the dermatophytes, the group also found that bisphosphonate-azole combinations could act against molds that cause invasive disease, suggesting another possible clinical application for the drugs.
"You can use these combinations directly for superficial infections, like Candida or dermatophyte infections, and we're hoping that with modified forms of the drugs we can create something that will also work systematically," Carter said. "The next step is to continue testing bisphosphonate-azole combinations in animal models, and then test it in clinical trials."
Fungal Infections Of The Skin
A fungal infection, also called mycosis, is a skin disease caused by a fungus.
There are millions of species of fungi. They live in the dirt, on plants, on household surfaces, and on your skin. Sometimes, they can lead to skin problems such as rashes or bumps.
Bacterial vs. Fungal skin infections
The key difference between bacterial and fungal infections is how doctors treat them. You'll take an antifungal medicine for a fungal infection, which could take a while to treat. Doctors prescribe antibiotics to treat bacterial infections, and these medicines work more quickly.
A fungal skin infection might cause:
Fungal skin infections can happen anywhere on your body. Some of the most common are athlete's foot, jock itch, ringworm, and yeast infections.
Athlete's foot
Athlete's foot, or tinea pedis, is a fungal infection of the foot. Fungi thrive in warm, moist environments such as shoes, socks, swimming pools, locker rooms, and public showers. This infection is more common in people who wear tight shoes, don't change sweaty socks, and use public baths and pools. The fungi responsible for athlete's foot live on the dead tissue of hair, toenails, and outer skin layers, with Trichophyton rubrum being the most common culprit.
Jock itch
Jock itch is also known as tinea cruris. A type of fungus called tinea causes this infection. This fungus thrives in warm, moist areas such as the genitals, inner thighs, and buttocks. Infections are more common during the summer or in warm, wet climates. Jock itch appears as a red, itchy, ring-shaped rash.
Jock itch is only mildly contagious, spreading through direct contact or indirectly via objects carrying the fungus. Symptoms include:
Ringworm
Ringworm, or tinea corporis, is a fungal skin infection named for its ring-shaped rash with a worm-like edge. Ringworm is contagious and can spread through direct contact with infected people or animals or by touching tainted clothing or furniture. Heat and humidity can help the spread of the infection. Symptoms include a red, circular, flat sore with scaly skin — where the outer part of the sore might be raised, while the middle appears normal. Red rings or patches may overlap.
Yeast infections
Yeast infections of your skin are called cutaneous candidiasis. A type of fungus called candida causes these infections when it grows too much. Yeast infections aren't contagious. They're most common in warm, moist, creased areas of your body, including your armpits and groin. They often happen in people with obesity or diabetes. Also, if you're taking an antibiotic, you are more likely to get a yeast infection.
Onychomycosis
Onychomycosis is a fungal infection that affects the nails on your fingers or toes. It causes your nails to become discolored, thickened, and sometimes separate from the nail bed. The condition is more common in older adults due to issues such as poor blood flow, immune system problems, and diabetes. Onychomycosis impacts toenails more often than fingernails because they grow more slowly, have less blood flow, and are usually in dark, moist conditions.
You're more likely to get a fungal skin infection if you:
To treat a fungal skin infection, you'll need antifungal medications, which can be topical (applied directly to your skin) or tablets (oral).
Topical antifungals
These medications come as creams, lotions, and shampoos. You can usually buy them from a pharmacist without a doctor's prescription. Examples include:
You may need to continue treatment for fungal nail infections for up to a year. For other types of infections, you should add up to 2 weeks of treatment after your symptoms have disappeared to make sure the infection doesn't return.
Always read the leaflet with your medication and ask a pharmacist any questions.
Antifungal tablets
If your infection doesn't get better after using an antifungal, it covers a large part of your skin or affects your nails or scalp, your doctor may prescribe antifungal tablets. Examples of antifungal tablets include:
You'll take this medicine for up to 6 months to completely get rid of your infection.
Here are steps you can take to lower your chances of getting a fungal skin infection:
Athlete's foot, also called tinea pedis, is a fungal infection of your foot.
The fungi grow best in warm, moist places such as shoes, socks, swimming pools, locker rooms, and public showers. They're often found in the summer and in hot, humid climates. It happens more often in people who wear tight shoes, don't change their sweaty socks, and use public baths and pools.
Athlete's foot causes
The fungi that cause athlete's foot live on the dead tissue of your hair, toenails, and outer skin layers. At least four kinds of fungus can cause the infection. The most common is Trichophyton rubrum.
Athlete's foot symptoms
Signs of athlete's foot vary from person to person. You might have:
Types of athlete's foot
Interdigital. This is also called toe web infection. Most people with athlete's foot have this form. It usually occurs between your two smallest toes. The infection can spread to the sole of your foot.
Moccasin. This form can begin with irritation, dryness, itching, or scaly skin. Over time, your skin may thicken and crack. This infection can involve your entire sole and extend to the sides of your foot.
Vesicular. This is the rarest kind of athlete's foot. It usually begins with a sudden outbreak of fluid-filled blisters, often on the underside of your foot. They also can appear between your toes, on your heel, or on top of your foot.
Athlete's foot diagnosis
Not all itchy, scaly feet are caused by a fungus. Your doctor may scrape off a bit of skin and look at it under a microscope to check for a different condition.
Athlete's foot treatment
Your doctor might give you antifungal medicine to put on your skin or, in severe cases, another kind to take by mouth. Be sure to keep your feet clean and dry.
Athlete's foot prevention
To keep from getting athlete's foot, wear shower sandals in public showering areas, wear shoes that let your feet breathe, and wash your feet every day with soap and water. Dry them thoroughly, and use a quality foot powder.
A type of fungus called tinea causes jock itch. The infection is also known as tinea cruris. Tinea loves warm, moist areas such as your genitals, inner thighs, and buttocks. Infections happen more often in the summer or warm, wet climates.
Jock itch is a red, itchy rash that's often ring-shaped.
Is jock itch contagious?
It's only mildly contagious. It can spread from person to person through direct contact or indirectly through objects with the fungus on them.
Jock itch symptoms
Symptoms of jock itch include:
Jock itch diagnosis
Doctors can usually diagnose it by what it looks like and where it is on your body. They might look at a sample of skin under a microscope to be sure.
Jock itch treatment
Keep the affected area clean and dry. Over-the-counter antifungal medicines can treat most cases of jock itch. In severe cases, your doctor might need to give you a prescription cream. No matter your treatment, be sure to:
Ringworm, also called tinea corporis, isn't a worm but a fungal skin infection. It's named for its ring-shaped rash with a winding, worm-like edge.
Is ringworm contagious?
Ringworm can spread through direct contact with infected people or animals. You can also pick it up off clothing or furniture. Heat and humidity can help spread the infection.
Ringworm symptoms
Ringworm is a red, circular, flat sore that can happen along with scaly skin. The outer part of the sore might be raised, while the skin in the middle appears normal. Patches or red rings may overlap.
Ringworm diagnosis
Your doctor can diagnose ringworm based on your symptoms. They might ask whether you've come into contact with infected people or animals. They might also take samples from the area and look at them under a microscope to be sure.
Ringworm treatment
Treatment usually involves antifungal medications that you put on your skin. You might use an over-the-counter cream such as:
In more severe cases, you might need prescription medications to put on your skin or take by mouth.
Yeast infections of your skin are called cutaneous candidiasis. A type of fungus called candida causes these infections when it grows too much. Yeast infections aren't contagious.
The infections are most common in warm, moist, creased areas of your body, including your armpits and groin. They often happen in people who are obese or who have diabetes. People taking antibiotics are also at higher risk.
Candida can cause diaper rash in infants. It can also cause infections in your nails, vagina, or mouth (oral thrush).
Yeast infection symptoms
Signs of a yeast infection on your skin include:
Signs of a yeast infection in your nail beds include:
Signs of thrush (yeast infection of your mouth) include:
Signs of a vaginal yeast infection include:
Yeast infection diagnosis
Your doctor will ask about your medical history and do a physical exam. They might also take a sample from the affected area to look at under a microscope.
Yeast infection treatment
Treatment depends on the infection. Medicated creams can treat most skin yeast infections. For a vaginal infection, you can usually use medicated suppositories. A medicated mouthwash or lozenges that dissolve in your mouth may treat oral thrush. If you have a severe infection or a weakened immune system, you might need anti-yeast medications that you take by mouth.
Fungal infections, or mycoses, are skin diseases caused by various fungi that live in warm and wet environments. Common types include athlete's foot, jock itch, ringworm, and yeast infections, each presenting with specific symptoms such as itching, redness, and rashes. These infections are often not serious but can be irritating and are easily spread through direct contact or shared items. Prevention involves good hygiene practices, such as keeping skin clean and dry, avoiding sharing personal items, and wearing protective footwear in public areas. Treatment typically involves topical antifungal medications, with more severe cases requiring oral antifungals.
UP Manila Develops Potent Herbal Solution For Fungal Skin Infections
The University of the Philippines Manila's National Integrated Research Program on Medicinal Plants (NIRPROMP) has created an herbal antifungal lotion using the Indigenous Akapulco plant (Senna Alata).
Skin fungal infections are among the most common complaints in dermatology and primary care clinics, affecting over a billion people globally. Highly contagious, these infections are particularly prevalent among Filipinos due to environmental factors like heat and humidity, as well as socioeconomic conditions such as overcrowding, poverty, and poor hygiene. Azole antifungals effectively treat these infections but are often expensive and require prolonged application.
"One solution to this problem is the use of Senna alata, more commonly known as Akapulco," said Dr. Cecilia Maramba-Lazarte, Director of the Institute of Herbal Medicine – National Institutes of Health (IHM-NIH).
Also known as Candlestick Bush, Akapulco is a perennial shrub widely distributed throughout the Philippines. It typically reaches one to two meters in height and features dense branches and leaves composed of eight to 20 oblong-elliptical leaflets. The plant is notable for its erect stalks that bear candle-like yellow flowers at their tips from where it derived its name. Apart from being valued for its distinctive appearance and ornamental qualities, the Candlestick Bush is also highly regarded for its potential natural remedies for specific ailments.
"Traditional healers and those of other cultures have used this to treat skin diseases. The antifungal activity of Akapulco has been well-documented in various studies," Dr. Lazarte explained.
Studies revealed that Akapulco contains several phytochemicals, including chrysophanic acid and anthraquinones. These plant-based compounds exhibit strong antifungal activity against Epidermophyton, Microsporum, Trichophyton, and Penicillium.
Randomized controlled trials
Dr. Lazarte stated that the effectiveness of Philippine akapulco preparations had been measured by the results of seven randomized controlled trials involving 726 patients. Four trials were performed using the NIRPROMP-IHM formulation, which enrolled 461 patients. These trials showed that preparations containing Akapulco are as efficacious as synthetic antifungal treatments containing 25 percent sodium thiosulfate, ketoconazole, or terbinafine cream. NIRPROMP co-founder and Mother of Philippine Herbal Medicine, Dr. Nelia Maramba led the trials.
Researchers noted minimal adverse effects from Akapulco lotion compared to conventional treatments.
"Randomized controlled trials are crucial to establish the efficacy and safety of treatments," noted Dr. Lazarte. "Our findings indicate that Akapulco lotion offers a cost-effective alternative to imported antifungal medications."
Dr. Lazarte said potential investors could capitalize on the global antifungal drug market, valued at $15.8 billion in 2023 and expected to expand further.
"By licensing our herbal medicine, pharmaceutical companies can tap into this expanding market," she emphasized.
Aside from economic benefits, the development of Akapulco lotion also bolsters local agriculture and champions Filipino self-reliance. "Our goal is to diminish dependence on imported drugs, bolster Filipino farmers, and offer an accessible treatment solution for fungal infections," she remarked.
NIRPROMP/IHM actively seeks partners to manufacture, distribute, and market Akapulco lotion as an antifungal remedy. NIRPROMP/IHM previously developed the well-regarded herbal medicines Lagundi and Sambong, which are now enjoying commercial success nationwide.
Comments
Post a Comment