Therapeutic and toxicologic studies in a murine model of invasive pulmonary aspergillosis

Med Mycol. 2011 Nov;49(8):834-47. doi: 10.3109/13693786.2011.577822. Epub 2011 May 4.


Invasive pulmonary aspergillosis remains problematic in immunocompromised patient populations. We studied potential therapeutic options in a murine model of pulmonary aspergillosis in triamcinolone-suppressed DBA/2 mice infected intranasally with conidia from Aspergillus fumigatus. Mice were treated with liposomal-amphotericin B (AmBi; AmBisome), lipid-complexed amphotericin B (ABLC; Abelcet), voriconazole (VCZ), micafungin (MICA), caspofungin (CAS) or deoxycholate amphotericin B (AMBd) given alone or in combination. Monotherapy with AmBi, ABLC, AMBd, CAS or MICA had activity in prolonging survival; however, only AMBd or CAS reduced fungal burden in the lungs and kidneys. Combinations of AmBi plus CAS or MICA prolonged survival, but were not better than monotherapy. VCZ was ineffective and AMBd plus CAS showed a possible antagonism. AmBi or ABLC at higher dosages, or loading-doses of AmBi resulted in reduced survival. Histopathology showed increased incidence of serious renal and mild hepatic toxicity in triamcinolone-treated mice given an amphotericin B regimen compared to no or only triamcinolone (minimal renal changes occurred with CAS or VCZ with or without triamcinolone); suggestive of combined toxicity of triamcinolone and the amphotericin B in AmBi or ABLC. Infected treated mice showed progressive pulmonary disease including abscesses, angioinvasion and abundant intralesional fungi. High loading-doses of AmBi were associated with nephrosis and damage to other tissues. No monotherapy or combination regimen showed superiority for the treatment of pulmonary aspergillosis in corticosteroid suppressed mice and the potential for combined drug toxicity was enhanced in these mice. High dosages of lipid-formulated amphotericin B also proved unsatisfactory. Additional studies are needed to evaluate improved treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use
  • Amphotericin B / toxicity
  • Animals
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use*
  • Antifungal Agents / toxicity
  • Aspergillus fumigatus / drug effects*
  • Caspofungin
  • Colony Count, Microbial
  • Deoxycholic Acid / administration & dosage
  • Deoxycholic Acid / therapeutic use
  • Deoxycholic Acid / toxicity
  • Disease Models, Animal
  • Drug Combinations
  • Drug Therapy, Combination
  • Echinocandins / administration & dosage
  • Echinocandins / therapeutic use
  • Echinocandins / toxicity
  • Humans
  • Invasive Pulmonary Aspergillosis / drug therapy*
  • Invasive Pulmonary Aspergillosis / mortality
  • Lipopeptides / administration & dosage
  • Lipopeptides / therapeutic use
  • Lipopeptides / toxicity
  • Male
  • Micafungin
  • Mice
  • Mice, Inbred DBA
  • Pyrimidines / administration & dosage
  • Pyrimidines / therapeutic use
  • Pyrimidines / toxicity
  • Triazoles / administration & dosage
  • Triazoles / therapeutic use
  • Triazoles / toxicity
  • Voriconazole


  • Antifungal Agents
  • Drug Combinations
  • Echinocandins
  • Lipopeptides
  • Pyrimidines
  • Triazoles
  • liposomal amphotericin B
  • Deoxycholic Acid
  • Amphotericin B
  • amphotericin B, deoxycholate drug combination
  • Caspofungin
  • Voriconazole
  • Micafungin