Topical Nanoemulsions as Delivery Systems for Green Extracts of Pterocaulon balansae Aiming at the Treatment of Sporotrichosis.

Coumarins are benzopyrones found in several plant genera, including Pterocaulon (Asteraceae). These compounds represent an important source of new treatments, especially as antimicrobial and antifungal agents. In this study, two coumarin-rich extracts from Pterocaulon balansae using green technologies were obtained through aqueous maceration (AE) and supercritical fluid extraction (SFE). Such extracts were incorporated into nanoemulsions (NAE and NSFE) composed of a medium-chain triglyceride oil core stabilized by phospholipids. The nanoemulsions exhibited droplet sizes between 127 and 162 nm, pH above 5.0, and viscosity of approximately 1.0 cP, properties compatible with the topical route. The coumarins permeation/retention from formulations through ear porcine skin using Franz-type diffusion cells were evaluated. Whatever the extract, coumarins were distributed in skin layers, especially in the dermis in both intact and impaired (tape stripping) skin. In addition, a significant increase in coumarins that reached up to the receptor fluid was observed for impaired skin, with increases of approximately threefold for NAE and fourfold for NSFE. Finally, antifungal activity of nanoemulsions was evaluated according to minimum inhibitory concentrations, and the values were 250 µg/mL for all strains tested. The overall results demonstrated the feasibility of incorporating P. balansae extracts into nanoemulsions and showed a potential alternative for the treatment of sporotrichosis.

Esporotricosis: la micosis subcutánea más frecuente en México / Sporotrichosis: the most frequent subcutaneous mycosis in Mexico

Resumen La esporotricosis es una micosis causada por especies del complejo Sporothrix schenckii. Basado en estudios epidemiológicos y moleculares. Se reconocen seis especies de Sporothrix como causantes de la esporotricosis humana. Algunas especies de este complejo, tienen un potencial zoonótico relevante para la transmisión al humano, y muchas otras son exclusivamente fitopatógenas. Es considerada la micosis subcutánea más frecuente en México. El principal mecanismo de infección es el traumatismo con pérdida de continuidad de la piel seguido por la contaminación con el hongo Sporothrix spp. Las principales formas clínicas son la esporotricosis linfangítica, la forma cutánea fija y la forma diseminada. Los procedimientos de laboratorio más útiles para confirmar el diagnóstico, son el cultivo de especímenes como exudado y tejido, así como el estudio histopatológico. La forma parasitaria está representada por levaduras en el tejido o exudados. Los medicamentos más útiles en el tratamiento son el yoduro de potasio y el itraconazol. La prevención es difícil; sin embargo, el uso de equipo protector durante las actividades laborales puede contribuir a evitar este padecimiento.

Abstract Sporotrichosis is a mycosis caused by fungal species that are part of the Sporothrix schenckii complex. Epidemiological and molecular studies have found only six species of the Sporothrix schenckii complex that cause infections in humans. Some species of this complex have a relevant zoonotic potential for transmission to humans, and some others only have phytopathogenic properties. It is considered the most frequent form of subcutaneous mycosis in Mexico. The main mechanism of infection a wound with loss of continuity of the skin followed by contamination with the fungus Sporothrix spp. The main clinical manifestations are lymphangitic sporotrichosis, fixed skin manifestation and disseminated manifestation. The most useful laboratory procedures to confirm the diagnosis are the cultivation of specimens such as exudate and tissue, as well as the histopathological study. The parasitic manifestation is represented by yeasts in the tissue or exudates. The most useful medications for its treatment are potassium iodide and itraconazole. Prevention is difficult; however, the use of protective equipment during work activities can help prevent this condition.

Esporotricosis cutánea: experiencia de un hospital de tercer nivel en Cali, Colombia / Cutaneous sporotrichosis: experience at a thirdlevel hospital in Cali, Colombia

Introducción: la esporotricosis es una micosis subcutánea causada por especies del complejo Sporothrix schenckii, que se adquiere por la inoculación traumática del hongo. Objetivo: describir los aspectos epidemiológicos y clínicos de un grupo de pacientes con esporotricosis. Metodología: se realizó un estudio retrospectivo, descriptivo en un hospital de referencia de la ciudad de Cali, entre enero de 2000 y junio de 2011; de los registros de laboratorio se seleccionaron los pacientes que presentaron cultivo positivo para S. sckenckii y/o tinción con ácido peryódico de Schiff (PAS)-diastasa positiva para blastoconidias compatibles con las de este complejo. Resultados: el grupo estuvo formado por 20 hombres y 3 mujeres; ocho (34,8%) de ellos se desempeñaban en la agricultura y cuatro (17,4%), en la construcción; seis (26,1%) fueron niños menores de 15 años. En 22 (95,7%) se aisló S. sckenckii y 15 de 21 (71,4%) mostraron blastoconidias en el examen directo. Hubo 14 casos (60,9%) de la forma linfangítica y nueve (39,1%) de la fija. La enfermedad se presentó en las extremidades superiores en 16 (69,6%) pacientes, en las inferiores en cuatro (17,4%) y en la cara en tres (13%). Se hizo tratamiento con yoduro de potasio en 22 pacientes (95,6%). Conclusiones: la esporotricosis linfangítica fue la forma clínica más común en este estudio. La coloración de PAS-diastasa mostró ser útil en el diagnóstico de la enfermedad.

Introduction: Sporotrichosis is a subcutaneous mycosis caused by the Sporothrix schenckii species complex; it is acquired by traumatic inoculation of the fungus. Objective: To describe the epidemiological and clinical features of a group of patients with sporotrichosis. Methodology: A retrospective and descriptive study was performed at a third-level hospital in Cali, Colombia, from January 2000 to June 2011. Records from patients having positive cultures for S. schenckii and/or periodic acid-Schiff (PAS)-diastase stain showing blastoconidia were included in the analysis. Results: The group was made up of 20 men and three women. Eight patients (34.8%) were farmers and four (17.4%) worked in construction activities. Six (26.1%) were children aged under 15 years. Sporothrix sckenckii was isolated from cultures in 22 patients (95%) and in 15 out of 21 (71.4%) blastoconidia were observed by direct examination. Fourteen patients (60.9%) had the lymphangitic form of the disease. Upper limbs were most frequently affected (16 cases; 69.6%). Twenty two patients were treated with potassium iodine. Conclusions: Lymphangitic sporotrichosis was the most common clinical form of the disease in this study. PAS-diastase stain seems to be a useful diagnostic tool for sporotrichosis.

Esporotricosis cutánea: revisión a propósito de un caso contraído en Chile / Cutaneous sporotrichosis: a Chilean case report

La esporotricosis es una infección subaguda a crónica causada por el hongo dimórf¡co Sporothrix schenckii, distribuido por todo el mundo, particularmente en climas templados y tropicales. La enfermedad afecta principalmente la piel y los vasos linfáticos, produciendo distintas formas clínicas, siendo la más frecuente la linfocutánea; sin embargo, puede ocurrir una diseminación a estructuras osteoarticulares y viscerales, especialmente en pacientes inmunosuprimidos. La infección linfocutánea generalmente se origina como consecuencia de traumas durante el trabajo al aire libre y la posterior inoculación del hongo a través de elementos contaminados, como el suelo, heno, espinas, madera y alambre de púas. La mayoría de los pacientes van a requerir tratamiento antimicótico, siendo el itraconazol el fármaco de elección. Además se utiliza ampliamente el yoduro de potasio en países subdesarrollados debido a su efectividad y bajo costo. Se presenta el caso de un paciente trabajador agrícola con esporotricosis cutánea, contraída en Chile, confirmada, que recibió tratamiento con itraconazol, evolucionando favorablemente.

Sporotrichosis is a sub acute to serious infection caused by a dimorphic fungus called Sporothrix schenckii, and disributed throughout the world, particularly in temperate and tropical climates. The disease affects mainly skin and lymph vessels, producing several clinical forms, most frequently lymphocutaneous. However, dissemination to musculoskeletal and visceral structures in immune suppressed patients may occur. Lymphocutaneous infection usually originates as a result of trauma during outdoor work and the subsequent inoculation of the fungus through contaminated objects such as soil, hay, thorns, wood and barbed wire. Most patients will require antifungal treatment; being itraconazole the drug of choice, Potassium iodine is widely used in developing countries due to its effectiveness and low cost we present the case of a farm worker with a confirmed cutaneous sporotrichosis infection contracted in Chile; the patient received itraconazole, with a favorable outcome.

Esporotricose experimental sistêmica em ratos Wistar: avaliação hematológica e perfil hepático / Systemic experimental sporotrichosis in Wistar rats: hematological evaluation and hepatic profile

Alanine aminotransferase (ALT) and alkaline phosphatase (AP) hepatic enzymes, hematological values, and total plasmatic proteins (TPP) of 12 Wistar rats with systemic experimental sporotrichosis were evaluated. Inoculation was performed at 2x10³ cells of S. schenckii/ml. The values ranged from 35 to 48UI/l for ALT and 67 to 251.3UI/l for AP. Fifty percent of the AP values were above the physiological limits. TPP was elevated in 66.7 percent (8/12) of the rats with values varying from 7.9 to 8.5g percent. In 75 percent (9/12) of the animals, it was observed that hemoglobin and red blood cells count were below the physiologic limits, and 8.3 percent (1/12) of the animals showed anemia masked by dehydration. At the necropsy, it was observed local and/or disseminated nodular lesions. At the histological analysis, cells compatible to S. schenckii were found. The observed alterations are aggravating factors for the recurrence and treatment of the mycosis.