Disease relevance of Mycoses

• Ketoconazole and itraconazole are effective in patients with the chronic, indolent forms of the endemic mycoses, including blastomycosis, coccidioidomycosis, and histoplasmosis; itraconazole is also effective in patients with sporotrichosis [1].
• Comparison of oral fluconazole and itraconazole for progressive, nonmeningeal coccidioidomycosis. A randomized, double-blind trial. Mycoses Study Group [2].
• SETTING: 26 MSG sites in the United States. PATIENTS: 33 patients with various deep and superficial mycoses who developed alopecia while receiving fluconazole [3].
• NIAID Mycoses Study Group Multicenter Trial of Oral Itraconazole Therapy for Invasive Aspergillosis [4].
• Polyuria and polydipsia developed in two cases during amphotericin B therapy for deep mycoses [5].

High impact information on Mycoses

• All three drugs are effective alternatives to amphotericin B and flucytosine as therapy for selected systemic mycoses [1].
• Differences in the recognition of glucan elicitor signals between rice and soybean: beta-glucan fragments from the rice blast disease fungus Pyricularia oryzae that elicit phytoalexin biosynthesis in suspension-cultured rice cells [6].
• Ketoconazole in systemic mycoses [7].
• Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses [8].
• Inhibitors of CYP51 include triazole antifungal agents fluconazole and itraconazole, drugs used in treatment of topical and systemic mycoses [9].

Chemical compound and disease context of Mycoses

• Compounds specifically interfering with chitin or beta-glucan synthesis have proven effective in studies of preclinical models of mycoses, though they appear to have a restricted spectrum of coverage [10].
• Ketoconazole, a new oral drug used to treat systemic and superficial mycoses, inhibits sterol synthesis in fungi [11].
• Terbinafine. An update of its use in superficial mycoses [12].
• The bis triazole agent fluconazole is used widely in the treatment of superficial and deep mycoses [13].
• Activity of MS-8209, a nonester amphotericin B derivative, in treatment of experimental systemic mycoses [14].

Biological context of Mycoses

• Fluconazole. An update of its pharmacodynamic and pharmacokinetic properties and therapeutic use in major superficial and systemic mycoses in immunocompromised patients [15].
• Cross reactions were not observed with any of the culture filtrates using sera from patients with other mycoses [16].
• Sertaconazole in the treatment of mycoses: from dermatology to gynecology [17].
• The aim of this review is to assess the epidemiology of alimentary tract mycoses in "at risk" groups because of iatrogenous or pathological reasons, such as in-patients undergoing solid organ and bone marrow transplantation, peritoneal dialysis and enteral/parenteral nutrition and in HIV infected patients [18].

Anatomical context of Mycoses

• In a separate series of 20 patients with mycoses fungoides, the anti-lymphoma antibody T-101 (recognizes the pan T-cell antigen, T-65), when labeled with indium-111, demonstrated lymph node involvement with greater sensitivity than conventional diagnostic methods and with excellent specificity [19].
• Cost-effectiveness analysis of treatment with liposomal amphotericin B versus conventional amphotericin B in organ or bone marrow transplant recipients with systemic mycoses [20].
• These results signify that the essential oil of Thymus vulgaris thymol chemotype potentiates the antifungal action of amphotericin B suggesting a possible utilization of this essential oil in addition to antifungal drugs for the treatment of mycoses [21].
• RECENT FINDINGS: Fluconazole-resistant Candida spp., Trichosporon spp., zygomycetous genera, the endemic mycoses, Scedosporium, Aspergillus, and Fusarium spp., and an ever-expanding list of lesser-known hyaline and phaeoid genera inciting invasive fungal infections comprise the bulk of refractory mycoses in the immune-compromised host [22].

Gene context of Mycoses

• This case should alert clinicians to the increased incidence of pulmonary mycoses in patients receiving anti-TNF-alpha therapy [23].
• At the same dilution, no reaction was detected with sera from normal individuals and from patients with other mycoses [24].
• For these reasons AME has been porposed as an alternative to amphotericin B in the therapy of deep mycoses [25].
• However, only 2.8% (3 of 109) of the serum samples from patients with other mycoses and nonmycotic infections showed IgM adsorption to the 120-kDa TP-Ag as detected by the ELISA, while 21.1% (23 of 109) showed IgM adsorption to the 110-kDa TP-Ag [26].
• This study provides preliminary evidence that ABCD is effective in treating invasive mycoses and lacks the dose-limiting nephrotoxicity of CAB [27].

Analytical, diagnostic and therapeutic context of Mycoses

• Forty-eight cases of deep mycoses were studied and treated with ketoconazole, each with in vitro evaluation of the minimum inhibitory concentrations (MIC) of the causative fungi, in vivo pharmacokinetic, clinical, and mycologic evaluations, several months to two years after the treatment was stopped [28].
• Cyclosporine (CsA) was associated with nearly a 4-fold risk of systemic mycoses less than 6 months from the time of transplantation as compared with prednisolone+azathioprine (PRED+AZA) therapy [29].
• Thus, routine monitoring of serum itraconazole concentrations in patients with life-threatening mycoses is essential for patient care [30].
• Eight patients with systemic mycoses and with prior treatment failures were treated with itraconazole (600 mg/day) for a mean duration of 5.5 months [31].
• The efficacy of i.v. itraconazole in these animal models justifies its further investigation for the treatment of life-threatening mycoses in humans [32].

References