The Effect of ketoconazole Drug in CD1a Expression among Sudanese Eumycetoma patients

Abstract

Eumycetoma is a chronic granulomatous fungal disease which is mainly caused by Madurella mycetomatis and treated by ketoconazole .This quasi experimental study aimed to assess the effect of long term ketoconazole therapy CD1a expression as label for epidermal dendritic cells in eumycetoma lesions. The study carried out in Soba University hospital, Sudan from January to September 2015.Sixty formalin fixed - paraffin embedded blocks (FFPB) were selected from Madurella mycetomatis eumycetoma patients, (30 of them were selected before ketoconazole therapy), then the remaining 30 blocks after ketoconazole therapy. FFPB were cut and stained with CD1a immunohistochemical method (new indirect method) for detection of Cd1a in epidermal dendritic cells then the expression was quantified and compared. Patients age range between 18 and 69 year, 22 (73.3%) patients were less than 40 years and 8 (26.7 %) patients were more than 40 years. In this study, males were 24 (80%) of the participants, and females were 6 (20%) of the participants with ratio 4:1. About mycetoma locations, 30 (100%) patients developed mycetoma in their feet. After quantification, pre treatment sections showed positive results with mean 62.33 ± 33.446, on the other hand the post treatment sections showed positive results with mean 17.63 ± 20.184. Based on these findings there is significant statistical association between treatment with KCZ and numerical reduction in CD1a expression (P.value = 0.000.) The study concludes that KCZ causes CD1a deficiency and this is compiling with need for more studies with larger sample size.