{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T11:40:23Z","timestamp":1784979623601,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,11,8]],"date-time":"2020-11-08T00:00:00Z","timestamp":1604793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81571970"],"award-info":[{"award-number":["81571970"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Trichosporiosis is an opportunistic infection that includes superficial infections, white piedra, hypersensitivity pneumonitis, and invasive trichosporonosis. The effect of antifungal agents against these infections is largely weakened by drug resistance and biofilms\u2010related virulence. Photodynamic therapy (PDT) is a new therapeutic approach developed not only to combat cancerous lesions but also to treat infectious diseases such as fungal infections. However, there are few studies on the antimicrobial mechanism of 5\u2010aminolevulinic acid PDT (ALA\u2010PDT) in treating <jats:italic>Trichosporon<\/jats:italic>. In this work, we explored the possibility of combining ALA\u2010PDT with an antifungal agent to enhance the therapeutic efficacy of <jats:italic>Trichosporon asahii<\/jats:italic> (<jats:italic>T. asahii<\/jats:italic>) in a clinical setting and <jats:italic>in vitro<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design\/Materials and Methods<\/jats:title><jats:p>The biofilms of <jats:italic>T. asahii<\/jats:italic> were constructed by a 96\u2010well plate\u2010based method <jats:italic>in vitro<\/jats:italic>. The planktonic and adherent <jats:italic>T. asahii<\/jats:italic> were exposed to different concentrations of photosensitizers and different light doses. After PDT treatment, counting colony\u2010forming units and tetrazolium (XTT) reduction assay were used to estimate the antifungal efficacy. The minimal inhibitory concentration of itraconazole before and after PDT treatment was determined by the broth dilution method, and XTT viability assay was used to detect and evaluate the synergistic potential of ALA\u2010PDT and itraconazole combinations in inhibiting biofilms. Scanning electron microscopy (SEM) was performed to assess the disruption of biofilms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using combination therapy, we have successfully treated a patient who had <jats:italic>a T. asahii<\/jats:italic> skin infection. Further <jats:italic>in vitro<\/jats:italic> studies showed that the antifungal effect of ALA\u2010PDT on planktonic and adherent <jats:italic>T. asahii<\/jats:italic> was dependent on the concentration of ALA and light dosages used. We also found that the sensitivity of both planktonic and biofilm cells to itraconazole were increased after ALA\u2010PDT. Synergistic effect were observed for biofilms in ALA\u2010PDT and itraconazole\u2010combined treatment. The disruption of biofilms was confirmed by SEM, suggesting that ALA\u2010PDT effectively damaged the biofilms and the destruction was further enhanced by ALA\u2010PDT combination of antifungal agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In conclusion, these data suggest that ALA\u2010PDT could be an alternative strategy for controlling infections caused by <jats:italic>Trichosporon<\/jats:italic>. The combination therapy of ALA\u2010PDT with itraconazole could result in increased elimination of planktonic cells and biofilms compared with single therapy. All these findings indicate that it could be a promising treatment against trichosporonosis. Lasers Surg. Med. \u00a9 2020 Wiley Periodicals LLC<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23343","type":"journal-article","created":{"date-parts":[[2020,11,8]],"date-time":"2020-11-08T18:34:52Z","timestamp":1604860492000},"page":"722-730","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Combinatory Effect of ALA\u2010PDT and Itraconazole Treatment for <i>Trichosporon asahii<\/i>"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6436-0505","authenticated-orcid":false,"given":"Yu","family":"Lan","sequence":"first","affiliation":[{"name":"Department of Dermatology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University  107 West Yanjiang Road Guangzhou 510120 China"},{"name":"Department of Dermatology, The Eighth Affiliated Hospital Sun Yat\u2010sen University  3025 Shennan Road Central Shenzhen 518033 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sha","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University  107 West Yanjiang Road Guangzhou 510120 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bowen","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University  107 West Yanjiang Road Guangzhou 510120 China"},{"name":"Department of Plastic Surgery, Nanfang Hospital Southern Medical University  1838 Guangzhou Avenue North Guangzhou 510515 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengqi","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University  107 West Yanjiang Road Guangzhou 510120 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University  107 West Yanjiang Road Guangzhou 510120 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junmin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University  107 West Yanjiang Road Guangzhou 510120 China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1004982"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00003-11"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2015.11.011"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000493374"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-015-9958-2"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01505-18"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fgb.2019.103267"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0109553"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micres.2007.08.001"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphotobiol.2016.02.027"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2019.01228"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphotobiol.2017.09.001"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-012-1050-2"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/nprot.2008.141"},{"key":"e_1_2_8_16_1","volume-title":"Reference method for broth dilution antifungal susceptibility testing of yeasts; approved standard\u2010third edition. 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