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1.
Nutrients ; 16(3)2024 Jan 24.
Article in English | MEDLINE | ID: mdl-38337625

ABSTRACT

Asthma is one of the most common chronic non-communicable diseases worldwide, characterized by variable airflow limitation secondary to airway narrowing, airway wall thickening, and increased mucus resulting from chronic inflammation and airway remodeling. Current epidemiological studies reported that hypovitaminosis D is frequent in patients with asthma and is associated with worsening the disease and that supplementation with vitamin D3 improves asthma symptoms. However, despite several advances in the field, the molecular mechanisms of asthma have yet to be comprehensively understood. MicroRNAs play an important role in controlling several biological processes and their deregulation is implicated in diverse diseases, including asthma. Evidence supports that the dysregulation of miR-21, miR-27b, miR-145, miR-146a, and miR-155 leads to disbalance of Th1/Th2 cells, inflammation, and airway remodeling, resulting in exacerbation of asthma. This review addresses how these molecular mechanisms explain the development of asthma and its exacerbation and how vitamin D3 may modulate these microRNAs to improve asthma symptoms.


Subject(s)
Asthma , MicroRNAs , Humans , Cholecalciferol/pharmacology , Cholecalciferol/therapeutic use , MicroRNAs/genetics , Airway Remodeling , Asthma/drug therapy , Asthma/genetics , Asthma/complications , Lung , Inflammation/complications , Dietary Supplements
2.
Microb Pathog ; 176: 106005, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36717005

ABSTRACT

The Gram-negative bacteria Brucella abortus is a major cause of brucellosis in animals and humans. The host innate immune response to B. abortus is mainly associated with phagocytic cells such as dendritic cells, neutrophils, and macrophages. However, as mast cells naturally reside in the main bacterial entry sites they may be involved in bacterial recognition. At present, little is known about the role of mast cells during B. abortus infection. The role of the innate immune receptors TLR2 and TLR4 in activation of mast cells by B. abortus (strain RB51) infection was analyzed in this study. The results showed that B. abortus did not induce mast cell degranulation, but did induce the synthesis of the cytokines IL-1ß, IL-6, TNF-α, CCL3, CCL4, and CCL5. Furthermore, B. abortus stimulated key cell signaling molecules involved in mast cell activation such as p38 and NF-κB. Blockade of the receptors TLR2 and TLR4 decreased TNF-α and IL-6 release by mast cells in response to B. abortus. Taken together, our results demonstrate that mast cells are activated by B. abortus and may play a role in inducing an inflammatory response during the initial phase of the infection.


Subject(s)
Brucella abortus , Brucellosis , Humans , Animals , Toll-Like Receptor 2 , Toll-Like Receptor 4 , Mast Cells , Tumor Necrosis Factor-alpha , Interleukin-6
3.
Vector Borne Zoonotic Dis ; 22(12): 589-595, 2022 12.
Article in English | MEDLINE | ID: mdl-36399687

ABSTRACT

Background: Leishmaniases are a group of vector-borne zoonotic diseases of public health relevance within the tropical and subtropical regions of the world. The state of Yucatan is a vulnerable and receptive area to localized cutaneous leishmaniasis (LCL) due to its proximity to the high-transmission endemic states of Campeche and Quintana Roo. Autochthonous cases of LCL caused by Leishmania (Leishmania) mexicana have been documented in the state, showing a geographical expansion of the disease. Materials and Methods: Using CO2-supplemented Centers for Disease Control and Prevention light traps and Shannon traps, we captured anthropophilic sandflies in the surroundings of a locality with recent records of autochthonous cases of LCL. Sandflies carrying Leishmania DNA were evidenced using PCR. Results: A total of 140 Phlebotominae (Diptera: Psychodidae) females of four species were captured: Lutzomyia (Tricholateralis) cruciata (Coquillett), Psathyromyia (Psathyromyia) shannoni (Dyar), Lutzomyia (Lutzomyia) longipalpis (Lutz and Neiva), and Dampfomyia (Coromyia) deleoni (Fairchild and Hertig). Molecular results showed that 6.1% (95% confidence interval [CI] = 2.3-12.9%) of Lu. cruciata and 43.8% (95% CI = 19.8-70.1%) of Pa. shannoni showed evidence of carrying L. (L.) mexicana DNA. Conclusion: We provide evidence of anthropophilic sandflies carrying L. mexicana DNA in a municipality with recorded autochthonous cases of LCL caused by this parasite species in the state of Yucatan, suggesting the emergence of new focus of LCL in Mexico.


Subject(s)
Leishmania mexicana , Psychodidae , Animals , Leishmania mexicana/classification , Leishmania mexicana/genetics , Leishmania mexicana/isolation & purification , Mexico , Psychodidae/parasitology
4.
Front Immunol ; 13: 897995, 2022.
Article in English | MEDLINE | ID: mdl-35860236

ABSTRACT

The contribution of the cellular immune response to the severity of coronavirus disease 2019 (COVID-19) is still uncertain because most evidence comes from patients receiving multiple drugs able to change immune function. Herein, we conducted a prospective cohort study and obtained blood samples from 128 unvaccinated healthy volunteers to examine the in vitro response pattern of CD4+ and CD8+ T cells and monocyte subsets to polyclonal stimuli, including anti-CD3, anti-CD28, poly I:C, severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) recombinant spike S1 protein, and lipopolysaccharide. Then, we started a six-month follow-up and registered 12 participants who got SARS-CoV-2 infection, from whom we retrospectively analyzed the basal immune response pattern of T cells and monocytes. Of the 12 participants infected, six participants developed mild COVID-19 with self-limiting symptoms such as fever, headache, and anosmia. Conversely, six other participants developed severe COVID-19 with pneumonia, respiratory distress, and hypoxia. Two severe COVID-19 cases required invasive mechanical ventilation. There were no differences between mild and severe cases for demographic, clinical, and biochemical baseline characteristics. In response to polyclonal stimuli, basal production of interleukin-2 (IL-2) and interferon (IFN-) gamma significantly decreased, and the programmed cell death protein 1 (PD-1) increased in CD4+ and CD8+ T cells from participants who posteriorly developed severe COVID-19 compared to mild cases. Likewise, CD14++CD16- classical and CD14+CD16+ non-classical monocytes lost their ability to produce IFN-alpha in response to polyclonal stimuli in participants who developed severe COVID-19 compared to mild cases. Of note, neither the total immunoglobulin G serum titers against the virus nor their neutralizing ability differed between mild and severe cases after a month of clinical recovery. In conclusion, using in vitro polyclonal stimuli, we found a basal immune response pattern associated with a predisposition to developing severe COVID-19, where high PD-1 expression and low IL-2 and IFN-gamma production in CD4+ and CD8+ T cells, and poor IFN-alpha expression in classical and non-classical monocytes are linked to disease worsening. Since antibody titers did not differ between mild and severe cases, these findings suggest cellular immunity may play a more crucial role than humoral immunity in preventing COVID-19 progression.


Subject(s)
COVID-19 , Humans , Immunity, Cellular , Interleukin-2 , Monocytes , Programmed Cell Death 1 Receptor , Prospective Studies , Retrospective Studies , SARS-CoV-2 , T-Lymphocytes
5.
Arch Med Res ; 52(7): 738-745, 2021 10.
Article in English | MEDLINE | ID: mdl-33926762

ABSTRACT

BACKGROUND: It has been observed that subjects with comorbidities related to metabolic syndrome (MetS) as hypertension, obesity, cardiovascular disease (CVD), and diabetes mellitus (DM2) show severe cases and a higher mortality by COVID-19. To date, there is little information available on the impact of the interaction between these comorbidities in the risk of death by COVID-19. AIM OF THE STUDY: To evaluate the impact of the combinations of MetS components in overall survival (OS) and risk of death among COVID-19 patients. METHODS: Using public data of the Ministry of Health, suspected, and confirmed COVID-19 cases from February 25-June 6, 2020 was analyzed. Mortality odds ratio (OR) was calculated with a univariate analysis (95% CI) and attributable risk. Interactions between components and survival curves were analyzed and a multivariate logistics regression analysis was conducted. RESULTS: The analysis included 528,651 cases out of which 202,951 were confirmed for COVID-19. Probabilities of OS among confirmed patients were 0.93, 0.89, 0.87, 0.86, and 0.83 while the OR of multivariate analysis was 1.83 (1.77-1.89), 2.58 (2.48-2.69), 2.83 (2.66-3.01), and 3.36 (2.83-3.99) for zero, one, two, three, and four MetS components, respectively. The combination with the highest risk was DM2 + hypertension at 2.22 (2.15-2.28), and the attributable risk for any component was 9.35% (9.21-9.49). Only the combination obesity + CVD showed no significant interaction. CONCLUSION: The presence of one MetS component doubles the risk of death by COVID-19, which was higher among patients with DM2 + hypertension. Only obesity and CVD do not interact significantly.


Subject(s)
COVID-19 , Diabetes Mellitus , Hypertension , Metabolic Syndrome , Comorbidity , Diabetes Mellitus/epidemiology , Humans , Hypertension/complications , Hypertension/epidemiology , Metabolic Syndrome/complications , Metabolic Syndrome/epidemiology , Risk Factors , SARS-CoV-2
7.
Med Hypotheses ; 134: 109527, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31877441

ABSTRACT

Obesity is a serious public health problem worldwide and has been associated in epidemiological studies with a unique type of non-atopic asthma, although the causal association of asthma and obesity has certain criteria, such as the strength of association, consistency, specificity, temporality, biological gradient, coherence, analogy and experimentation; nevertheless, the biological plausibility of this association remains uncertain. Various mechanisms have been postulated, such as immunological, hormonal, mechanical, environmental, genetic and epigenetic mechanisms. Our hypothesis favours immunological mechanisms because some cytokines, such as tumour necrosis factor alpha (TNF-α) and interleukin (IL)-17A, are responsible for orchestrating low-grade systemic inflammation associated with obesity; however, these cytokines are regulated by epigenetic mechanisms, such as gene promoter methylation.


Subject(s)
Asthma/etiology , DNA Methylation , Interleukin-17/genetics , Models, Immunological , Nuclear Receptor Subfamily 1, Group F, Member 3/genetics , Obesity/complications , Promoter Regions, Genetic , Th17 Cells/metabolism , Tumor Necrosis Factor-alpha/genetics , Adipose Tissue/metabolism , Adolescent , Adult , Animals , Asthma/genetics , Asthma/immunology , Causality , Child , Female , Gene Expression Regulation , Humans , Inflammation , Interleukin-23/physiology , Macrophages/metabolism , Male , Meta-Analysis as Topic , Mice , Middle Aged , Nuclear Receptor Subfamily 1, Group F, Member 3/physiology , Obesity/immunology , Tumor Necrosis Factor-alpha/physiology
8.
Colloids Surf B Biointerfaces ; 177: 77-93, 2019 May 01.
Article in English | MEDLINE | ID: mdl-30711762

ABSTRACT

Peptide epitopes have been widely used to develop synthetic vaccines and immunotherapies. However, peptide epitopes may exhibit poor absorption or immunogenicity due to their low molecular weights. Conversely, fourth-generation polyamidoamine (G4-PAMAM) dendrimers are nonimmunogenic and relatively nontoxic synthetic nanoparticles that have been used as adjuvants and nanocarriers of small peptides and to improve nasal absorption. Based on this information, we hypothesized that the combination of intranasal immunization and G4-PAMAM dendrimers would be useful for enhancing the antibody responses of HIV-1 gp120 peptide epitopes. Therefore, we first used structural data, peptide epitope predictors and docking and MD simulations on MHC-II to identify two peptide epitopes on the CD4 binding site of HIV-1 gp120. The formation of G4-PAMAM-peptide complexes was evaluated in silico (molecular docking studies using different G4-PAMAM conformations retrieved from MD simulations as well as the MMGBSA approach) and validated experimentally (electrophoresis, 1H NMR and cryo-TEM). Next, the G4-PAMAM dendrimer-peptide complexes were administered intranasally to groups of female BALB/cJ mice. The results showed that both peptides were immunogenic at the systemic and mucosal levels (nasal and vaginal), and G4-PAMAM dendrimer-peptide complexes improved IgG and IgA responses in serum and nasal washes. Thus, G4-PAMAM dendrimers have potential for use as adjuvants and nanocarriers of peptides.


Subject(s)
Computer Simulation , Dendrimers/chemistry , HIV Envelope Protein gp120/chemistry , HIV-1/chemistry , HIV-1/immunology , Models, Molecular , Nylons/chemistry , Peptides/chemistry , Peptides/immunology , Animals , Female , HIV Envelope Protein gp120/genetics , HIV Envelope Protein gp120/immunology , Mice , Mice, Inbred BALB C , Peptides/genetics
9.
J Immunol Res ; 2017: 1236219, 2017.
Article in English | MEDLINE | ID: mdl-28164135

ABSTRACT

CD8+ T cells that secrete proinflammatory cytokines play a central role in exacerbation of inflammation; however, a new subpopulation of CD8 regulatory T cells has recently been characterized. This study analyzes the prominent role of these different subpopulations in the development of graft-versus-host disease (GVHD). Samples from 8 healthy donors mobilized with Filgrastim® (G-CSF) and 18 patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) were evaluated by flow cytometry. Mobilization induced an increase in Tc1 (p < 0.01), Th1 (p < 0.001), Tc17 (p < 0.05), and CD8+IL-10+ cells (p < 0.05), showing that G-CSF induces both pro- and anti-inflammatory profiles. Donor-patient correlation revealed a trend (p = 0.06) toward the development of GVHD in patients who receive a high percentage of Tc1 cells. Patients with acute GVHD (aGVHD), either active or controlled, and patients without GVHD were evaluated; patients with active aGVHD had a higher percentage of Tc1 (p < 0.01) and Tc17 (p < 0.05) cells, as opposed to patients without GVHD in whom a higher percentage of CD8 Treg cells (p < 0.01) was found. These findings indicate that the increase in Tc1 and Tc17 cells is associated with GVHD development, while regulatory CD8 T cells might have a protective role in this disease. These tests can be used to monitor and control GVHD.


Subject(s)
Graft vs Host Disease/immunology , Granulocyte Colony-Stimulating Factor/immunology , Hematopoietic Stem Cell Transplantation , T-Lymphocyte Subsets/immunology , T-Lymphocytes, Cytotoxic/immunology , T-Lymphocytes, Regulatory/immunology , Adolescent , Adult , Female , Filgrastim/therapeutic use , Flow Cytometry , Humans , Male , Middle Aged , Young Adult
10.
Immunobiology ; 220(9): 1093-100, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26001731

ABSTRACT

Mast cells are crucial elements of the innate immune response. They reside in tissues that are commonly exposed to the external environment, such as the skin and mucosae, where they can rapidly detect the presence of pathogens and mount a potent inflammatory response that recruits other cellular effectors of the immune response. The contribution of mast cells to the immune response to viruses, bacteria, protozoa and multicellular parasites is well established, but there is scarce information about the role of these cells in fungal infections. In this study, we analyzed if mast cells are activated by Candida albicans and if the C-type lectin receptor Dectin-1 is involved in its recognition. We found that both yeasts and hyphae of C. albicans-induced mast cell degranulation and production of TNF-α, IL-6, IL-10, CCL3 and CCL4, while only yeasts were able to induce IL-1ß. Mast cells also produced ROS after stimulation with both dimorphic phases of C. albicans. When mast cells were activated with yeasts and hyphae, they showed decreased expression of IκBα and increased presence of phosphorylated Syk. Blockade of the receptor Dectin-1, but not Toll-like receptor 2, decreased TNF-α production by mast cell in response to C. albicans. These results indicate that mast cells are capable of sensing the two phases of C. albicans, and suggest that mast cells participate as an early inductor of inflammation during the early innate immune response to this fungus.


Subject(s)
Candida albicans/immunology , Cell Degranulation/immunology , Inflammation/immunology , Lectins, C-Type/immunology , Mast Cells/immunology , Animals , Cells, Cultured , Chemokine CCL3/biosynthesis , Chemokine CCL4/biosynthesis , Hyphae/immunology , I-kappa B Kinase/metabolism , Interleukin-10/biosynthesis , Interleukin-1beta/biosynthesis , Interleukin-6/biosynthesis , Intracellular Signaling Peptides and Proteins/metabolism , Male , Phosphorylation/immunology , Protein-Tyrosine Kinases/metabolism , Rats , Rats, Sprague-Dawley , Reactive Oxygen Species/metabolism , Syk Kinase , Tumor Necrosis Factor-alpha/biosynthesis , Yeasts/immunology
11.
Nat Prod Commun ; 9(6): 853-6, 2014 Jun.
Article in English | MEDLINE | ID: mdl-25115098

ABSTRACT

Dialyzable leukocyte extracts (DLE) transfer specific cell-mediated immune responses from sensitized donors to non-immune recipients. In addition, DLE have several immunomodulatory effects and are used for the treatment of several infectious and non-infectious diseases. Previous studies showed that human DLE obtained from virus-infected leukocytes and bovine DLE decrease the production of the pro-inflammatory cytokine TNF-alpha in response to bacterial lipopolysaccharide, in vitro and in vivo. In the present work, we inquire as to whether DLE from uninfected human leukocytes have the ability to regulate cytokine production in peripheral blood mononuclear cells (PBMC) in vitro. We observed that PBMC from healthy individuals were able to produce TNF-alpha, IL-12 and IL-10 after stimulation with DLE. Moreover, we identified monocytes as the main cell population that produced TNF-alpha after DLE stimulation. Interestingly, we found that DLE contain unidentified ligands that activate Toll-like receptor (TLR)-2. Finally, we observed that DLE directly activated monocytes through TLR-2. These results reveal a new biological activity of DLE, and suggest that part of the immunomodulatory properties of DLE could be attributed to TLR-2 activation on monocytes and to the induction of a pro-inflammatory environment that is crucial for control of infectious diseases.


Subject(s)
Cell Extracts/pharmacology , Leukocytes/chemistry , Monocytes/drug effects , Toll-Like Receptor 2/metabolism , Animals , Cell Extracts/chemistry , Gene Expression Regulation/drug effects , Humans , Monocytes/metabolism , Toll-Like Receptor 2/genetics
12.
Microbiol Immunol ; 58(2): 87-95, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24372854

ABSTRACT

Colonization of epithelium by microorganisms leads to inflammatory responses. In some cases an anti-apoptotic response involving the cellular inhibitor of apoptosis protein-2 (cIAP-2) also occurs. Although strong expression of cIAP-2 has been observed in lesional skin from psoriatic patients and in HaCaT keratinocytes treated with peptidoglycan (PGN) from Staphylococcus aureus, anti-apoptotic responses induced in the skin by cIAP-2 have seldom been studied. In this study, the effect of PGN on TNF-α-induced apoptotic HaCaT keratinocytes was assessed. Morphological analysis, quantification of cells with DNA fragmentation and active caspase-3 detection was performed to assess apoptotic cell death. Greater LL-37 and cIAP-2 production was found in keratinocytes stimulated with PGN than in non-treated cells (P < 0.05). In comparison with cells treated with TNF-α only, a significant reduction in apoptotic cell death was observed when HaCaT were pretreated with PGN before inducing apoptosis with TNF-α (P < 0.05). In addition, an inhibitor of cIAP-2 activity (LCL161) stopped the PGN effect. These findings show that PGN from S. aureus has an anti-apoptotic effect in keratinocytes mediated by cIAP-2 production, suggesting that this anti-apoptotic activity could favor proliferation of keratinocytes in psoriasis.


Subject(s)
Apoptosis , Inhibitor of Apoptosis Proteins/biosynthesis , Keratinocytes/metabolism , Keratinocytes/microbiology , Peptidoglycan/metabolism , Staphylococcus aureus/metabolism , Antimicrobial Cationic Peptides/genetics , Apoptosis/drug effects , Cell Line , Gene Expression , Humans , Inhibitor of Apoptosis Proteins/genetics , Interleukin-8/genetics , Keratinocytes/drug effects , Peptidoglycan/pharmacology , Tumor Necrosis Factor-alpha/metabolism , Tumor Necrosis Factor-alpha/pharmacology , Cathelicidins
13.
J Proteomics ; 74(12): 2959-71, 2011 Nov 18.
Article in English | MEDLINE | ID: mdl-21875698

ABSTRACT

Brucella abortus is an alpha-2 proteobacteria with a type IV secretion system (T4SS) known as virB, which is necessary to gain virulence by building up a replicative vacuole associated with the endoplasmic reticulum of the host cell. A virB T4SS mutant of the B. abortus 2308 strain and its wild-type strain were grown in acid medium in order to obtain and analyze their proteomes, looking for putative proteins that may serve as T4SS substrates and those that may be subjected to T4SS regulation. A total of 47 overexpressed and 22 underexpressed proteins from the virB T4SS mutant strain were selected and sequenced. Some of the 69 analyzed proteins have not been described before either as over or under-expressed in relation to a virB T4SS mutation, whereas some of them have been already described by other groups as potentially important secretory proteins in other Brucella species. An important number of the proteins identified are outer membrane and periplasmic space protein, which makes them become particularly important new T4SS-related candidate proteins.


Subject(s)
Bacterial Outer Membrane Proteins/biosynthesis , Bacterial Secretion Systems , Brucella abortus/metabolism , Gene Expression Regulation, Bacterial , Mutation , Periplasmic Proteins/biosynthesis , Proteome/biosynthesis , Bacterial Outer Membrane Proteins/genetics , Brucella abortus/genetics , Periplasmic Proteins/genetics , Proteome/genetics
14.
J Clin Apher ; 25(4): 181-7, 2010.
Article in English | MEDLINE | ID: mdl-20818712

ABSTRACT

Hematopoietic stem cells transplantation (HSCT) is the leading curative therapy for a variety of hematological and hereditary diseases; however, graft versus host disease (GVHD), an immunologic phenomenon that is favored by Th1 cytokines and cytotoxic cells from donors, is present frequently and is one of the most important causes of transplant related mortality. Peripheral blood HSCT is the preferred source of stem cells in almost 100% of the cases of autologous HSCT and in 70% of allogeneic transplants. The best mobilizing agent to get the stem cells out from the bone marrow is the Granulocyte-Colony Stimulating Factor (G-CSF). In this work, our main objective was to study a possible correlation between the graft cell dose and the patient's clinical outcome. We evaluated the immunologic changes produced by G-CSF in the lymphocyte and cytokine profiles in allogeneic HSC donors. HSC from twelve donors were mobilized with G-CSF at 16 microg/kg/day, for 5 days. Basal Peripheral Blood (BPB), Mobilized Peripheral Blood (MPB), and aphaeresis mononuclear cells (G-MNC) samples were taken from all donors. Using flow cytometry, we quantified CD19(+), CD3(+), CD3(+)CD4(+), CD3(+)CD8(+), NK, NKT, DC1, and DC2 cells. Cytokines were determined by ELISA in culture supernatants. CD19(+) (p = 0.001), DC1 (p < 0.002) and DC2 (p < 0.001) cells were increased in MPB with respect to BPB. An increase in Th2 cytokines such as (IL-4) and a decrease in Th1 cytokines (IFNgamma, IL-2) were also found in MPB samples. In conclusion, Th1 and Th2 cytokines are relevant in predicting the clinical outcome after allogeneic peripheral blood HSCT.


Subject(s)
Granulocyte Colony-Stimulating Factor/administration & dosage , Hematopoietic Stem Cell Mobilization/methods , Interferon-gamma/analysis , Interleukin-4/analysis , T-Lymphocyte Subsets/cytology , Adolescent , Adult , Blood Component Removal , Cell Count , Child , Cytokines/analysis , Cytokines/metabolism , Female , Granulocyte Colony-Stimulating Factor/pharmacology , Hematopoietic Stem Cell Transplantation/methods , Humans , Immunophenotyping , Male , Middle Aged , Peripheral Blood Stem Cell Transplantation/methods , Th1 Cells/metabolism , Th2 Cells/metabolism , Treatment Outcome , Young Adult
15.
Med Mycol ; 47(1): 111-4, 2009 Feb.
Article in English | MEDLINE | ID: mdl-19031337

ABSTRACT

A 57-year-old male presented with dermatosis of the dorsum of the foot consisting of tumefaction, deformity and sinus tract formation. The direct examination of exudates as well as the biopsy tissue, demonstrated the presence of black granules. A dematiaceous fungus was isolated from the lesions and was identified by ribosomal DNA sequencing as Cladophialophora bantiana. This is the second report of this fungus as an etiologic agent of eumycetoma in humans. Clinical and mycologic cure was achieved after 20 months of treatment with itraconazole at a starting dose of 300 mg/day that was tapered during the course of therapy. The patient's isolate had an itraconazole MIC of 0.012 microg/ml.


Subject(s)
Antifungal Agents/therapeutic use , Ascomycota/isolation & purification , Foot Dermatoses , Itraconazole/therapeutic use , Mycetoma , Ascomycota/classification , Ascomycota/drug effects , Ascomycota/genetics , Foot Dermatoses/drug therapy , Foot Dermatoses/microbiology , Foot Dermatoses/pathology , Humans , Male , Middle Aged , Mycetoma/drug therapy , Mycetoma/microbiology , Mycetoma/pathology , Treatment Outcome
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