Effect of Voriconazole and Ultraviolet-A Combination Therapy Compared to Voriconazole Single Treatment on Fusarium solani Fungal Keratitis
Effect of Voriconazole and Ultraviolet-A Combination Therapy Compared to Voriconazole Single Treatment on Fusarium solani Fungal Keratitis
复制标题
DOI：
10.1089/jop.2013.0167
复制
发表时间：
2014-06-01
影响因子：
2.3
通讯作者：
Seo, Kyoung Yul
中科院分区：
文献类型：
--
作者：
Choi, Kyoung Sub;Yoon, Sang Chul;Seo, Kyoung Yul
目的：为证明紫外线A（UV-A）和伏立康唑联合治疗真菌性角膜炎比伏立康唑单独治疗更有效。用不同的UV-A照射剂量照射每种真菌溶液。此外，还用UV-A照射含有伏立康唑的真菌溶液。在兔角膜炎模型中研究了UV-A和伏立康唑治疗的体内治疗效果。将真菌注射到16只家兔的角膜基质中。在真菌注射后3天开始每次处理，并持续至以下组的8天：第1组，对照;第2组，每天用UV-A处理一次;第3组，每天用伏立康唑处理3次;第4组，每天用伏立康唑处理3次和每天用UV-A处理一次。最后一天，取出巩膜-角膜扣，进行微生物学和组织学评价。结果：随着UV-A照射，培养物中真菌溶液的菌落形成单位（CFUs）显着减少。含有伏立康唑的真菌溶液的CFU也随着UV-A照射而降低。在体内，治疗后5天，组3（P = 0.03）和组4（P = 0.02）的临床评分显著低于组1。治疗后5天，第4组（P = 0.03）的临床评分显著低于第3组。治疗后5天，第4组的组织病理学评分显著低于第1组（P <0.01）和第3组（P = 0.02）。根据我们的CFU分析，与第1组相比，只有第4组的CFU显着降低（P = 0.04）。结论：UV-A和伏立康唑联合治疗可能是伏立康唑单一治疗真菌性角膜炎的安全有效的替代方案。
Purpose: To demonstrate that ultraviolet-A (UV-A) and voriconazole combination therapy is more effective than voriconazole single treatment for fungal keratitis.Methods: The in vitro UV-A (375 nm) fungicidal effect was evaluated on Fusarium solani solutions. Each fungal solution was irradiated with different UV-A irradiation doses. Also, a fungal solution containing voriconazole was also irradiated with UV-A. The in vivo therapeutic effect of UV-A and voriconazole treatment was studied in a rabbit keratitis model. Fungi were injected intrastromally into the cornea of 16 rabbits. Each treatment was initiated 3 days after fungal injection and continued up to 8 days for the following groups: Group 1, control; Group 2, treated with UV-A once a day; Group 3, treated with voriconazole 3 times a day; Group 4, treated with voriconazole 3 times a day and UV-A once a day. On the last day, the sclera-cornea buttons were extracted and microbiological and histological evaluations were performed.Results: The colony-forming units (CFUs) of fungal solutions in culture significantly decreased with UV-A irradiation. The CFUs of fungal solutions containing voriconazole also decreased with UV-A irradiation. In vivo, clinical scores of Group 3 (P = 0.03) and Group 4 (P = 0.02) 5 days after treatment were significantly lower compared to that of Group 1. The clinical score of Group 4 (P = 0.03) 5 days after treatment was significantly lower compared to that of Group 3. The histopathological scores 5 days after treatment were significantly lower in Group 4 compared to those of Group 1 (P < 0.01) and Group 3 (P = 0.02). Based on our CFU analysis, only Group 4 showed significantly lower CFUs compared to Group 1 (P = 0.04).Conclusions: UV-A and voriconazole combination treatment could be a safe and effective alternative to voriconazole single treatment for fungal keratitis.