title: An investigation into the inhibitory effect of ultraviolet radiation on Trichophyton rubrum.
abstract: Fungal infection of nails, onychomycosis, is predominantly caused by Trichophyton rubrum. This infection is an important public health concern due to its persistent nature and high recurrence rates. Alternative treatments are urgently required. One such alternative is phototherapy involving the action of photothermal or photochemical processes. The aim of this novel study was to assess which wavelengths within the ultraviolet (UV) spectrum were inhibitory and equally important nail transmissible. Initial irradiations of T. rubrum spore suspensions were carried out using a tunable wavelength lamp system (fluence ≤3.1 J/cm(2)) at wavelengths between 280 and 400 nm (UVC to UVA) to evaluate which wavelengths prevented fungal growth. Light-emitting diodes (LEDs) of defined wavelengths were subsequently chosen with a view to evaluate and potentially implement this technology as a low-cost "in-home" treatment. Our experiments demonstrated that exposure at 280 nm using an LED with a fluence as low as 0.5 J/cm(2) was inhibitory, i.e., no growth following a 2-week incubation (p < 0.05; one-way ANOVA), while exposure to longer wavelengths was not. A key requirement for the use of phototherapy in the treatment of onychomycosis is that it must be nail transmissible. Our results indicate that the treatment with UVC is not feasible given that there is no overlap between the antifungal activity observed at 280 nm and transmission through the nail plate. However, a potential indirect application of this technology could be the decontamination of reservoirs of infection such as the shoes of infected individuals, thus preventing reinfection.
authors.affiliation: School of Science and Health, University of Western Sydney, Campbelltown, NSW, 2560, Australia.
authors.forename: Leah J
authors.initials: LJ
authors.lastname: Cronin
authors.forename: Richard P
authors.initials: RP
authors.lastname: Mildren
authors.forename: Michelle
authors.initials: M
authors.lastname: Moffitt
authors.forename: Antonio
authors.initials: A
authors.lastname: Lauto
authors.forename: C Oliver
authors.initials: CO
authors.lastname: Morton
authors.forename: Colin M
authors.initials: CM
authors.lastname: Stack
mesh_terms: D005533:Foot Dermatoses / Q000382:microbiology / Q000532:radiotherapy; D006801:Humans; D009262:Nails / Q000382:microbiology / Q000528:radiation effects; D014009:Onychomycosis / Q000382:microbiology / Q000532:radiotherapy*; D055620:Optical Phenomena; D010789:Phototherapy / Q000379:methods; D013172:Spores, Fungal / Q000528:radiation effects; D014249:Trichophyton / Q000472:pathogenicity / Q000528:radiation effects*; D014466:Ultraviolet Rays; D014467:Ultraviolet Therapy / Q000379:methods*