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Topical and device-based treatments for fungal infections of the toenails.

ABSTRACT:

SUBMITTER: Foley K

PROVIDER: S-EPMC6984586 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Topical and device-based treatments for fungal infections of the toenails.

Foley Kelly K Gupta Aditya K AK Gupta Aditya K AK Versteeg Sarah S Mays Rachel R Villanueva Elmer E John Denny D

The Cochrane database of systematic reviews 20200116

<h4>Background</h4>Onychomycosis refers to fungal infections of the nail apparatus that may cause pain, discomfort, and disfigurement. This is an update of a Cochrane Review published in 2007; a substantial amount of new research warrants a review exclusively on toenails.<h4>Objectives</h4>To assess the clinical and mycological effects of topical drugs and device-based therapies for toenail onychomycosis.<h4>Search methods</h4>We searched the following databases up to May 2019: the Cochrane Skin ...[more]

PMID: 31978269

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Project description:Sepsis is a clinical syndrome that can be caused by bacteria or fungi. Early knowledge on the nature of the causative agent is a prerequisite for targeted anti-microbial therapy. Besides currently used detection methods like blood culture and PCR-based assays, the analysis of the transcriptional response of the host to infecting organisms holds great promise. In this study, we aim to examine the transcriptional footprint of infections caused by the bacterial pathogens Staphylococcus aureus and Escherichia coli and the fungal pathogens Candida albicans and Aspergillus fumigatus in a human whole-blood model. Moreover, we use the expression information to build a random forest classifier to determine if the pathogen is bacterial, fungal or neither of the two. After normalizing the transcription intensities using stably expressed reference genes, we filtered the gene set for biomarkers of bacterial or fungal blood infections. This selection is based on differential expression and an additional gene relevance measure. In this way, we identified 38 biomarker genes, including IL6, SOCS3, and IRG1 which were already associated to sepsis by other studies. Using these genes, we trained the classifier and assessed its performance. It yielded a 96% accuracy (sensitivities >93%, specificities >97%) for a 10-fold stratified cross-validation and a 92% accuracy (sensitivities and specificities >83%) for an additional dataset comprising Cryptococcus neoformans infections. Furthermore, the noise-robustness of the classifier suggests high rates of correct class predictions on datasets of new species. In conclusion, this genome-wide approach demonstrates an effective feature selection process in combination with the construction of a well-performing classification model. Further analyses of genes with pathogen-dependent expression patterns can provide insights into the systemic host responses, which may lead to new anti-microbial therapeutic advances. Analysis of innate immune activation on the basis of gene expression of whole blood cells during ex vivo whole blood infection with bacterial (Staphylococcus aureus, Escherichia coli) and fungal pathogens (Candida albicans, Aspergillus fumigatus) in comparison to mock-treated blood.

Dataset Information

Topical and device-based treatments for fungal infections of the toenails.

Publications

Topical and device-based treatments for fungal infections of the toenails.

Similar Datasets

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