Fluconazole and amphotericin B antifungal therapies do not negate the protective effect of endogenous tumor necrosis factor in a murine model of fatal disseminated candidiasis

J Infect Dis. 1995 Feb;171(2):406-15. doi: 10.1093/infdis/171.2.406.

Abstract

In systemic candidiasis, endogenously produced tumor necrosis factor (TNF)-alpha prolongs survival of the infected host. To determine whether endogenously produced TNF-alpha has a beneficial effect beyond that provided by antifungal therapy, survival was assessed in infected mice that received fluconazole or amphotericin B alone and in combination with anti-TNF-alpha antibody. Neutralization of serum TNF-alpha did not affect survival in fluconazole recipients; however, for amphotericin B recipients, it significantly shortened mean survival. For both fluconazole and amphotericin B recipients, colony counts in organs were significantly higher in animals that also received anti-TNF-alpha antibody. Administration of anti-TNF-alpha antibody with amphotericin B or fluconazole did not affect the morphology of fungi or the inflammatory response in kidneys. This study suggests that exogenous TNF-alpha and drugs that increase the endogenous production of TNF-alpha by the host may be useful adjuncts to fluconazole and amphotericin B for the treatment of systemic candidiasis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Amphotericin B / therapeutic use*
  • Animals
  • Candidiasis / drug therapy*
  • Candidiasis / mortality
  • Colony Count, Microbial
  • Female
  • Fluconazole / therapeutic use*
  • Immunoglobulin G / pharmacology
  • Interleukin-6 / biosynthesis*
  • Kidney / microbiology
  • Leukocyte Count
  • Liver / microbiology
  • Lung / microbiology
  • Macrophages, Peritoneal / metabolism
  • Mice
  • Spleen / microbiology
  • Survival Analysis
  • Tissue Distribution
  • Tumor Necrosis Factor-alpha / biosynthesis
  • Tumor Necrosis Factor-alpha / immunology
  • Tumor Necrosis Factor-alpha / physiology*

Substances

  • Immunoglobulin G
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Amphotericin B
  • Fluconazole