Amorolfine 5% Nail Lacquer Exhibits Potent Antifungal Activity Compared to Three Acid-Based Devices Indicated for the Treatment of Onychomycosis: An In Vitro Nail Penetration Assay

Ghannoum, Mahmoud A.; Sevin, Karine; Sarkany, Marlis

doi:10.1007/s13555-016-0093-x

Cited by 10 publications

(9 citation statements)

References 16 publications

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“…Both were more effective than fluconazole and bifonazole against dermatophytes as well as slightly more potent against candida than terbinafine after 4 days of incubation and at concentrations of ≥10 μg/ml, although the specific sporicidal mechanism for the different antimycotics is still unknown. In a vitro nail penetration model (Ghannoum, Sevin, & Sarkany, ), it shows that even small amounts of amorolfine alone reaching the nail bed inhibit or kill the pathogens, its use is far more better than three acid‐based devices which turns out the PH cannot be low enough to be fungicidal. And in another in vitro study (Seidl et al, ), amorolfine demonstrated significant sporicidal effectiveness on dormant T. rubrum and C. albicans cells even at the lowest tested concentration of 1μg/ml.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of amorolfine 5% nail lacquer in combination with systemic antifungal agents for onychomycosis: A meta-analysis and systematic review

Feng

Xiong

Ran

2017

Dermatologic Therapy

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The efficacy and safety of amorolfine 5% nail lacquer in combination with systemic antifungal agents in the treatment of the onychomycosis were evaluated. According to our meta-analysis, combination treatment of amorolfine 5% nail lacquer and systemic antifungals can result in higher percentage of complete clearance of onychomycosis. It showed that the experimental combination group was more effective than monotherapy of the systemic antifungals [OR (odds ratio) = 1.97, 95%CI (95% confidence interval) = 1.44-2.69], and no more adverse events happened with the addition of amorolfine 5% nail lacquer (OR = .96, 95%CI = .56-1.63, p = .95). This effect strengthens the fact that amorolfine 5% nail lacquer in combination with systemic antifungal agents was better than the monotherapy of systemic antifungals like itraconazole and terbinafine.

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Section: Discussionmentioning

confidence: 99%

Efficacy and tolerability of amorolfine 5% nail lacquer in combination with systemic antifungal agents for onychomycosis: A meta-analysis and systematic review

Feng

Xiong

Ran

2017

Dermatologic Therapy

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“…The agar diffusion assay was developed to determine the antifungal activity, measured as ZOI, of amorolfine 5% NL (a microtiter plate assay could not be used due to the opacity of the test agents). The disc‐diffusion method has been widely used to determine the antifungal activity of drugs, and this assay has been described previously . Since there is no standard method for the disc‐diffusion susceptibility testing of dermatophytes, it was necessary to arbitrarily select a ZOI size that could be reproducibly interpreted.…”

Section: Discussionmentioning

confidence: 99%

Application of cosmetic nail varnish does not affect the antifungal efficacy of amorolfine 5% nail lacquer in the treatment of distal subungual toenail onychomycosis: results of a randomised active‐controlled study and in vitro assays

Sigurgeirsson¹,

Ghannoum

Osman‐Ponchet

et al. 2016

Mycoses

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SummaryAs onychomycosis is unsightly, this study clinically evaluated whether the antifungal efficacy of amorolfine 5% nail lacquer (NL) was affected by a masking, naturalcoloured, cosmetic nail varnish applied 24 h later; in vitro investigations were also performed. Subjects with mild-to-moderate distal subungual toenail onychomycosis were randomised to receive amorolfine 5% NL once weekly with or without cosmetic nail varnish applied 24 h later. After 12-week treatment, antifungal activity of affected toenail clippings was assessed by measurement of zones of inhibition (ZOIs) on Trichophyton mentagrophytes seeded agar plates. Mean diameters were 53.5 mm for the amorolfine 5% NL-alone group (n = 23) and 53.6 mm for amorolfine 5% NL plus cosmetic nail varnish group (n = 25). Also, mycological cultures of subungual debris at week 12 were negative for all subjects in both groups. Most subjects (88%) reported that cosmetic nail varnish masked their infected toenails. Additionally, cadaver human nails coated in vitro with or without cosmetic nail varnish 10 min or 24 h post amorolfine NL application all gave ZOIs on Trichophyton rubrum agar plates representing potent antifungal activity. In conclusion, cosmetic nail varnish applied post amorolfine had no effect on the subungual antifungal activity of amorolfine 5% NL or its penetration through toenails.

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“…Both tests allowed the development of the fungus in an ideal habitat, but as previously mentioned, when it is intended to evaluate the antifungal activity of some agent in the nail powder, the rigid barrier present in the nail plate that hinders the penetration of the drugs is absent in this case. Another model of dermatophyte infection was that of Ghannoum et al, who used nails removed from fresh human cadavers to check the antifungal potential of a topical solution. This onychomycosis model is easy to reproduce and has been developed with care to ensure that the antifungal effects result from the penetration of the test compound into the nail plate.…”

Section: Alternative Methods That Simulate Fungal Infectionsmentioning

confidence: 99%

Fungal infection models: Current progress ofex vivomethods

Quatrin

Lana

Kaminski

2019

Mycoses

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| INTRODUC TI ONThe principles developed by Russell and Burch in 1959, concerning the use of animals in research, have been updated in recent decades, and cover the use of tissues from dead animals as alternatives to in vivo methods. 1 In vivo tests generally involve a large number of specimens to obtain representative results, and the well-being of these animals has become an ethical issue to be respected. 2 The term ex vivo refers to the use of living tissues, which are removed from an organism in vivo, for the application in experiments that will be performed in an artificial environment. 3The murine models used to evaluate the therapeutic profile of new antifungal agents are addressed in several studies, such as induction of keratitis, onychomycosis, and systemic, vaginal, pulmonary and cutaneous infections. 4-9 However, it is important to maintain a balance between qualified science and animal well-being, using rational and ethical ways of research. In this scenario, ex vivo models that simulate fungal infections in nails, mucous membranes and skin are promising alternatives that have been showing considerable results. [10][11][12] In order to demonstrate new perspectives in the evaluation of antifungal therapy, we will approach a critical review of the main ex vivo techniques used in the simulation and treatment of mycoses, providing an adaptation of the widely used in vivo methods. | ME THODS | Data source SummaryExperimental alternative ex vivo models that simulate infectious processes in vivo are of fundamental importance for the evaluation of new drugs, since in some cases, their execution does not depend on the approval of an ethics committee in research.Although studies using alternative infectious models to evaluate the efficacy of antifungal molecules have been increasingly described and reported, there is no critical consensus that establishes the most appropriate ones regarding the type of infection. Numerous studies contemplate ex vivo protocols of fungal infections on nails, corneas, dentinal tubules and skin and reveal counterpoints and concordances not yet finely confronted. In this minireview, we propose a critical analysis of the main ex vivo models of fungal infections for the evaluation of new antifungal candidates for both topical and systemic use, as opposed to the advantages and disadvantages of the traditional in vivo models employed in preclinical research. K E Y W O R D S dentinal tubule infections, ex vivo models, mucosal infections, onychomycosis, skin infection, systemic infections | 861 MACIEL QUATRIN ET AL. How to cite this article: Maciel Quatrin P, Flores Dalla Lana D, Andrzejewski Kaminski TF, Meneghello Fuentefria A. Fungal infection models: Current progress of ex vivo methods.

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Amorolfine 5% Nail Lacquer Exhibits Potent Antifungal Activity Compared to Three Acid-Based Devices Indicated for the Treatment of Onychomycosis: An In Vitro Nail Penetration Assay

Cited by 10 publications

References 16 publications

Efficacy and tolerability of amorolfine 5% nail lacquer in combination with systemic antifungal agents for onychomycosis: A meta-analysis and systematic review

Efficacy and tolerability of amorolfine 5% nail lacquer in combination with systemic antifungal agents for onychomycosis: A meta-analysis and systematic review

Application of cosmetic nail varnish does not affect the antifungal efficacy of amorolfine 5% nail lacquer in the treatment of distal subungual toenail onychomycosis: results of a randomised active‐controlled study and in vitro assays

Fungal infection models: Current progress ofex vivomethods

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