ORIGINAL PAPER Intravenous Injection of Micafungin Counteracts Candida Albicans-Induced Aggravation of Duodenal Ulcers Caused by Cysteamine in Rats Tetsuya Nakamura Æ Masashi Yoshida Æ Yuko Kitagawa Æ Longxue Jin Æ Hideki Ishikawa Æ Kaori Kameyama Æ Go Wakabayashi Æ Minoru Tanabe Æ Shigeyuki Kawachi Æ Masahiro Shinoda Æ Yoshiro Saikawa Æ Norihito Wada Æ Tetsuro Kubota Æ Koichiro Kumai Æ Katsuko Sano Æ Masaki Kitajima Received: 16 May 2007 / Accepted: 26 November 2007 / Published online: 19 January 2008 Ó Springer Science+Business Media, LLC 2007 Abstract Background We have reported previously that Candida albicans is involved in the pathogenesis of peptic ulcer perforation; it was shown that C. albicans aggravated the severity of duodenal ulceration and increased the rate of perforation. We considered it incumbent upon us to ascertain whether C. albicans is a virulence factor involved in peptic ulcer perforation. In the present study, we administered an antifungal drug (micafungin) intrave- nously to rats that had received intragastric (i.g.) administration of C. albicans and cysteamine, in order to examine that micafungin could counteract the C. albicans- aggravation of duodenal ulcers. Methods Cysteamine was administered thrice on day 1 to male Wistar rats. C. albi- cans was administered to the animals 1 h before, and 12 and 24 h after the first administration of cysteamine. Micafungin (n = 22) or saline (n = 24) was administered 12, 24, and 48 h after the administration of cysteamine. Results The area of the duodenal ulcers was also signifi- cantly smaller in the micafungin group (P \ 0.05). In addition, the survival rate of the rats was significantly higher in the micafungin group (P \ 0.05). While in the control group, the ulcer base was found to be colonized by C. albicans, there was no evidence of the presence of C. albicans in the micafungin group. Conclusion It was shown that intravenous injection of micafungin counter- acted the aggravation by C. albicans of cysteamine- induced duodenal ulcers in rats. This finding supports the concept that C. albicans is an aggravating factor for peptic ulcers. Keywords Candida Á Ulcer Á Perforation Á Micafungin Á Antifungal drug Á Cysteamine Á Infection Introduction We have previously reported that Candida albicans aggravates duodenal ulceration and increases the rate of perforation of peptic ulcers [1]. Since no other experi- mental study has been published to date on the aggravation of duodenal ulcers by C. albicans, we con- sidered it incumbent upon us to accumulate experimental evidence to demonstrate that C. albicans is indeed a virulence factor involved in peptic ulcer perforation. In the present study, we administered the antifungal drug T. Nakamura (&) Á Y. Kitagawa Á L. Jin Á M. Tanabe Á S. Kawachi Á M. Shinoda Á Y. Saikawa Á N. Wada Á K. Sano Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo 160-8582, Japan e-mail: tetsuyan@vesta.dti.ne.jp M. Yoshida Á M. Kitajima Center for Digestive Disease, International University of Health and Welfare, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan H. Ishikawa Department of Surgery, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, Japan K. Kameyama Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan G. Wakabayashi 1st Department of Surgery, Iwate University School of Medicine, 19-1 Uchimaru, Morioka-shi, Iwate 020-8505, Japan T. Kubota Center for Comprehensive and Advanced Medicine, Keio University School of Medicine, Tokyo, Japan K. Kumai Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan 123 Dig Dis Sci (2008) 53:2422–2428 DOI 10.1007/s10620-007-0159-9