ABSTRACT
Disseminated candidiasis is a serious problem in public health that results from the invasion of Candida species, in particular Candida albicans. The aim of this study was to compare the efficacies of Zataria multiflora essential oil and itraconazole in clearing C. albicans from the visceral organs of BALB/c mice suffered from disseminated candidiasis. Zataria multiflora essential oil was extracted using Clevenger-type apparatus and analyzed by gas chromatography mass spectrometry (GC-MS). For clearance experiment, mice (20-25 g, N=8 per group) received essential oil at doses of 30, 48 and 64 mg/kg and itraconazole at dose of 200 mg/kg intraperitoneally (IP) 2 days before and after intravenous inoculation of 0.5×10(6) C. albicans blastospores. The treated animals were sacrificed on day 20, and 0.1 g of the tissue homogenates was plated onto specific media. In GC-Mass, the main components of the essential oil were carvacrol (61.29 percent) and thymol (25.18 percent). The results demonstrated that IP administration of 64 mg/kg of the essential oil had the highest efficacy in reducing C. albicans and produced 39.5, 21.8, 141.5, 174 and 501-fold reductions in mean CFUs per 0.1 gram in Candida infections of the liver, spleen, lungs, brain and kidneys, respectively, compared to positive control. Itraconazole showed significantly more responsiveness than the essential oil at dose of 30 mg/kg in clearing C. albicans from the kidneys (P<0.02), brain (P<0.02) and spleen (P<0.04), and less responsiveness than that of 64 mg/kg in clearing the organism from the brain (P<0.01), lungs (P<0.0005) and kidneys (P<0.0005), whereas no significant difference was observed between this drug and Z. multiflora at dose of 48 mg/kg. These data explain the increased rate of yeast clearance and reduced dissemination to the viscera of Z. multiflora treated mice.
A candidíase disseminada é um problema sério de saúde publica decorrente da invasão por espécies de Candida, e Candida albicans em particular. O objetivo deste estudo foi comparar a eficiência do óleo essencial de Zataria multiflora e itraconazol na remoção de C. albicans das vísceras de camundongos BALB/c com candidíase disseminada. O óleo essencial de Zataria multiflora foi extraído empregando um aparelho do tipo Clevenger e analisado por cromatografia a gás e espectrometria de massa (GC-MS). Para os experimentos de remoção, camundongos (20-25g, n=8 por grupo) receberam óleo essencial nas doses de 30, 48 e 64 mg/kg e itraconazol na dose de 200 mg/kg via intraperitoneal (IP) por dois dias antes e após a inoculação intravenosa de 0,5 x 10(6) blastósporos de C. albicans. Os animais tratados foram sacrificados no vigésimo dia e 0,1g dos tecidos homogeneizados foram semeados em meios específicos. De acordo com o GC-MS, os principais componentes do óleo essencial foram carvacrol (61,29 por cento) e timol (25,28 por cento). Os resultados mostraram que a administração IP de 64 mg/kg de óleo essencial apresentou a eficiência mais alta na redução de C. albicans e resultou na redução de 39,5, 21,8, 141,5, 174 e 501 vezes na contagem média de C. albicans por 0,1g do fígado, baço, pulmões, cérebro e rins, respectivamente, quando comparado ao controle positivo. O itraconazol apresentou redução de C. albicans maior do que o óleo essencial na dose de 30mg/kg nos rins (P<0,02), cérebro (P<0,02) e baço (P<0,04) e menor no cérebro (P<0,01), pulmões (P<0,0005) e rins (P<0,0005) na dose de 64 mg/kg, enquanto não houve diferença entre esse droga e óleo essencial na dose de 48mg/kg. Estes resultados explicam a remoção aumentada de leveduras e a disseminação reduzida para as vísceras de camundongos tratados com Z. multiflora.
ABSTRACT
To examine the relationship between host survival and the type of immune response in different organs during disseminated candidiasis, the murine model of disseminated candidiasis was established by injection with Candida albicans via tail vein. The survival time was observed for up to 60 days. And the expression levels of cytokines in the spleen and kidney, including IFN-γ and IL-4, were determined with RT-PCR. Our results showed that in the spleen, both non-fatal and fatal inoculum caused a type Ⅱ immune response with steady expression levels of IFN-γ and the obviously increased levels of IL-4. While in the kidney, non-fatal inoculum induced a type Ⅰ immune response with the obviously increased levels of IFN-γ and the steady expression levels of IL-4. However, fatal inoculum induced a type Ⅱ immune response with a constant expression of IFN-γ and the evidently increased levels of IL-4. It is concluded that in disseminated candidiasis, host survival is associated with the type of immune responses in the kidney, but not in the spleen.
ABSTRACT
Candida species are pervasive pathogens capable of causing both local and systemic infections in hospitalized patients. Hematogenously disseminated candidiasis is a life-threatening infection that is associated with high mortality because of nonspecific symptoms and low culture positivity. Nosocomial disseminated candidiasis has increased during the last decade. Although several advances in the diagnosis and treatment of this serious infection have been made in recent years, early diagnosis has been difficult until now. We experienced a case of disseminated candidiasis, which developed during treatment of toxic epidermal necrolysis with steroid and antibiotics. The patient manifested with endopthalmitis, multiple pulmonary nodular infiltrates and spondylodiscitis. Disseminated candidiasis was confirmed by transbronchial lung biopsy and treated with amphotericin B.