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Cold atmospheric plasma improves antifungal responsiveness of Aspergillus flavus and Fusarium keratoplasticum conidia and mycelia

Summary

Researchers tested a new treatment called cold atmospheric plasma (CAP) combined with antifungal medications against fungi that cause serious eye infections. CAP, which generates reactive molecules without heat, was found to make antifungal drugs work better against two major fungal pathogens. In some cases, drugs that previously didn’t work started working when combined with CAP. This approach could help treat difficult fungal eye infections that are resistant to standard medications.

Background

Fungal keratitis is a serious ocular disease affecting over 2 million individuals annually, with Aspergillus and Fusarium species being leading causes. Treatment options are severely limited to three main antifungal agents, with increasing reports of drug resistance and biofilm formation complicating infections.

Objective

This study evaluated whether sublethal cold atmospheric plasma (CAP) treatment enhances susceptibility of filamentous fungal pathogens to commonly used antifungal drugs in vitro. The goal was to determine if CAP pretreatment improves antifungal response in A. flavus and F. keratoplasticum conidia and biofilms.

Results

CAP enhanced antifungal drug efficacy across all fungal species tested, with effects varying by drug and growth form. Notable findings include fourfold reduction in caspofungin MIC for F. keratoplasticum conidia and restoration of fluconazole sensitivity in previously resistant strains. F. keratoplasticum biofilms showed sustained metabolic suppression with CAP and antifungal combinations, while A. flavus biofilms exhibited partial recovery.

Conclusion

Sublethal CAP treatment significantly enhances antifungal susceptibility in fungal keratitis pathogens, with species- and drug-dependent effects. CAP shows promise as an adjunctive therapy for fungal infections, particularly in overcoming antifungal resistance, though responses vary between conidial and biofilm forms.
  • Published in:PLoS One,
  • Study Type:In vitro experimental study,
  • Source: PMID: 40788917, DOI: 10.1371/journal.pone.0326940
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