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Caspofungin benefit on phagocytes from patients with renal dysfunction infected with multidrug-resistant Candida

Giuliana Banche1, Narcisa Mandras, Franca Giacchino

  • 1Department of Public Health & Pediatrics, University of Torino, Via Santena 9, 10126 Turin, Italy.

Future Microbiology
|July 10, 2013
PubMed
Abstract

Insights

Caspofungin (CAS) enhances polymorphonuclear leukocyte (PMN) function in hemodialyzed patients (HDs) and renal transplant recipients (RTRs). This improves their ability to fight multidrug-resistant Candida glabrata, suggesting CAS as a therapeutic option.

Area of Science:

  • Immunology
  • Pharmacology
  • Mycology

Background:

  • Polymorphonuclear leukocytes (PMNs) play a crucial role in innate immunity.
  • Patients undergoing hemodialysis (HDs) and renal transplant recipients (RTRs) often exhibit impaired immune function.
  • Multidrug-resistant strains of Candida glabrata pose a significant threat in immunocompromised populations.

Purpose of the Study:

  • To investigate the impact of caspofungin (CAS) on the functional activities of PMNs from HDs and RTRs.
  • To assess the efficacy of CAS against a multidrug-resistant Candida glabrata strain.
  • To compare PMN activity in HDs and RTRs with healthy subjects (HSs) in the presence of CAS.

Main Methods:

  • Evaluated PMN phagocytosis and intracellular killing activities.
  • Utilized a multidrug-resistant clinical strain of Candida glabrata.
  • Tested PMNs from 66 HDs, 54 RTRs, and 30 HSs with and without CAS at minimum inhibitory concentrations (MICs) and sub-MICs.

Main Results:

  • CAS significantly enhanced the fungicidal activity of PMNs from HDs and RTRs against multidrug-resistant C. glabrata.
  • The improved fungicidal activity in HD and RTR PMNs approached levels observed in HS PMNs.
  • Survival index values indicated restored PMN function in the presence of CAS.

Conclusions:

  • Caspofungin (CAS) plays a role in restoring impaired PMN functions in hemodialyzed patients (HDs) and renal transplant recipients (RTRs).
  • CAS may be an effective treatment for invasive fungal infections caused by multidrug-resistant C. glabrata in patients with compromised innate immunity.
  • This study highlights the potential of CAS in managing fungal infections in vulnerable patient populations.

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