Disulfiram inhibits IL-1β secretion and inflammatory cells recruitment in Aspergillus fumigatus keratitis

Purpose: Disulfiram, an inhibitor of gasdermin D-induced pore formation, is known to suppress interleukin (IL)-1β secretion and Pyroptosis. However, its effects on Fungal keratitis remain unknown. Therefore, we investigated the role of disulfiram in Aspergillus fumigatus keratitis.

Methods: In vitro, Cell Count Kit-8 (CCK8) assay and cell scratch test were performed to determine optimal concentration. In vivo and in vitro experiments were conducted in a mouse model, human neutrophils, and mouse peritoneal macrophages. We pre-treated the mice or cells with disulfiram and infected them with A. fumigatus at specific times. We subsequently evaluated the development of Fungal keratitis lesions, the recruitment of inflammatory cells, and the production of inflammatory cytokines using slit lamp microscopy, clinical evaluation, quantitative reverse transcription polymerase chain reaction, immunofluorescence staining, enzyme-linked immunosorbent assay, and western blotting. We also used slit lamp microscopy and clinical evaluation to assess the effect of natamycin with or without disulfiram.

Results: Disulfiram at 20 μM has no significant cytotoxic effect and does not affect cell migration. In the mouse model, disulfiram significantly suppressed inflammatory responses, reduced neutrophil and macrophage recruitment, and down-regulated myeloperoxidase and nitric oxide synthase levels at earlier stages of Infection. Disulfiram had no effect on IL-1β production and maturation, but it inhibited IL-1β secretion in macrophages. Disulfiram combined with natamycin significantly increased corneal transparency in the mice model.

Conclusion: Overall, disulfiram reduced the host immune response in Fungal keratitis by attenuating neutrophil and macrophage recruitment and inhibiting IL-1β secretion in macrophages. Disulfiram in combination with Antifungal agents may serve as a novel therapeutic method for reducing corneal opacity in Fungal keratitis.