Fungal
keratitis is one of the most common blindness-causing diseases,
but clinical antifungal treatment remains a challenge. The fungal
cell wall and biofilm matrix which severely confine the drug preparation
are the critical obstructive factors to therapeutic effects. Herein,
we report ethylenediaminetetraacetic acid (EDTA) modified AgCu2O nanoparticles (AgCuE NPs) to disrupt the cell wall and then
eradicate C. albicans through the internal
cascade synergistic effects of ion-released chemotherapy, chemodynamic
therapy, photodynamic therapy, and mild photothermal therapy. AgCuE
NPs exhibited excellent antifungal activity both in preventing biofilm
formation and in destroying mature biofilms. Furthermore, AgCuE NP
based gel formulations were topically applied to kill fungi, reduce
inflammation, and promote wound healing, using optical coherence tomography
and photoacoustic imaging to monitor nanogel retention and therapeutic
effects on the infected murine cornea model. The AgCuE NP gel showed
good biosafety and no obvious ophthalmic and systemic side effects.
This study suggests that the AgCuE NP gel is an effective and safe
antifungal strategy for fungal keratitis with a favorable prognosis
and potential for clinical translation.