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In vitro studies on the antifungal effect of PUVA

Insights

Photochemotherapy using 8-methoxypsoralen (8-MOP) with ultraviolet A (UVA) light is fungicidal against dermatophytes and Candida albicans. This combination therapy shows potential for treating fungal infections, though some mould fungi exhibit resistance.

Area of Science:

  • Dermatology
  • Photobiology
  • Mycology

Background:

  • Fungal infections caused by dermatophytes, Candida albicans, and moulds pose significant health challenges.
  • Photochemotherapy, specifically PUVA (psoralen plus ultraviolet A), is a known treatment modality for various skin conditions.
  • The antifungal efficacy of PUVA therapy against common human fungal pathogens remains an area for detailed investigation.

Purpose of the Study:

  • To evaluate the in vitro fungicidal and fungistatic effects of PUVA therapy on clinically relevant fungal strains.
  • To determine the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of 8-methoxypsoralen (8-MOP) combined with UVA radiation.
  • To compare the efficacy of PUVA therapy against dermatophytes, Candida albicans, and various mould fungi.

Main Methods:

  • The agar dilution method was employed using Sabouraud agar medium.
  • Standardized fungal strains, including 12 dermatophytes, 3 Candida albicans, and 4 mould fungi, were tested.
  • Varying concentrations of 8-MOP (8-methoxypsoralen) were combined with specific doses of UVA radiation (4 J/cm² and 1-2 J/cm²).

Main Results:

  • A dose of 30 µg/ml 8-MOP plus 4 J/cm² UVA demonstrated fungicidal activity against all tested dermatophyte and Candida albicans strains.
  • Three mould fungi strains showed resistance to the fungicidal effects of 8-MOP and UVA combination.
  • Minimum Inhibitory Concentrations (MICs) for dermatophytes and Candida albicans ranged from 1-3 µg/ml 8-MOP with 4 J/cm² UVA, and 3 µg/ml with 1-2 J/cm² UVA.
  • Minimum Fungicidal Concentrations (MFCs) varied from 2-30 µg/ml 8-MOP at 4 J/cm² UVA, and reached 16 J/cm² UVA with 4 µg/ml 8-MOP.
  • 8-MOP alone exhibited inhibitory effects on dermatophytes but not on Candida albicans or mould fungi.

Conclusions:

  • PUVA therapy, specifically 8-MOP combined with adequate UVA dosage, is a potent fungicidal agent against dermatophytes and Candida albicans.
  • The study highlights potential resistance in certain mould fungi, indicating the need for further investigation into treatment strategies for these pathogens.
  • The findings support the consideration of PUVA therapy as a viable treatment option for specific superficial fungal infections.

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