Rutin resists Aspergillus fumigatus keratitis by activating Nrf2/HO-1 pathway, inhibiting Dectin-1/p-Syk pathway and affecting fungal structures.

Fungal keratitis (FK) is a severe vision-threatening eye disease. The fungal invasiveness and excessive inflammatory response contribute to corneal tissue damage. Rutin (RT) possesses anti-inflammatory, antimicrobial, antioxidant, and improved wound-healing characteristics. This study aimed to evaluate antifungal, anti-inflammatory, and therapeutic effects of RT in FK. The results showed that RT exerted antifungal effects by inhibiting fungal growth, altering hyphal morphology, destroying biofilm, and disrupting fungal cellular structures. RT exhibited anti-inflammatory benefits by suppressing the Dectin-1/p-Syk pathway, activating the Nrf2/HO-1 pathway, and decreasing the expression of inflammatory factors in vivo and in vitro. RT demonstrated therapeutic effects by reducing clinical scores, fungal load, macrophage recruitment, and neutrophil activity. In conclusion, RT exhibited anti-inflammatory, antifungal, and therapeutic effects in Aspergillus fumigatus keratitis, and has the potential to become a novel therapeutic strategy for FK.